Clinical trial NCT03569878: IT Enhanced Peer Integrated Collaborative Care for US Trauma Care Systems
Official title: A Comparative Effectiveness Trial of an Information Technology Enhanced Peer-Integrated Collaborative Care Intervention for US Trauma Care Systems
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: NA
Conditions: PTSD
Physical Injury
Keywords: PTSD
Physical Injury
Patient Concerns
Emergency Department Utilization
Lead sponsor: University of Washington
Sponsor class: OTHER
Collaborators: name: Patient-Centered Outcomes Research Institute
First posted: 2018-06-26
Enrollment: 450
Sex: ALL
Minimum age (years): 18
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Allocation: RANDOMIZED
Intervention model: PARALLEL
Primary purpose: TREATMENT

Brief summary: This study evaluates two readily implementable approaches to the delivery of transitional care for injured patients treated emergently in US trauma care systems. The two approaches to be compared are a multidisciplinary team collaborative care intervention that integrates front-line trauma center staff with peer interventionists to trauma surgical team notification of patient emotional distress with recommended mental health consultation. The collaborative care intervention will be supported by a novel Emergency Department (ED) health information exchange technology platform.

Detailed description: Collaborative care models are an established standard of care for treating combined mental health and chronic medical conditions in acute and primary care medical settings. However, very few interventions exist for the acute injury population transitioning between settings. While peer interventionist programs have been instituted for care delivery in many conditions, they have not yet been comprehensively integrated into acute post-injury interventions. Literature reviews support the need for comparative effectiveness trials of health care system interventions targeting high need injured patients with multiple complex mental health and medical comorbidities who are at risk for fragmented post-injury health service utilization. This study evaluates two readily implementable approaches to the delivery of transitional care for injured patients treated emergently in US trauma care systems. The two approaches to be compared are a multidisciplinary team collaborative care intervention that integrates front-line trauma center staff with peer interventionists to trauma surgical team notification of patient emotional distress with recommended mental health consultation. The collaborative care intervention will be supported by a novel Emergency Department (ED) health information exchange technology platform.

Eligibility criteria: Inclusion Criteria:

* Inpatient/emergency admission for intentional and/or unintentional injury
* Score of ≥35 on the PTSD checklist
* Endorsement of ≥ 1 severe posttraumatic concern

Exclusion Criteria:

* Patients who required immediate psychiatric intervention
* Patients who are not Washington or Oregon State residents
* Patients who are currently incarcerated
* Patients not speaking Spanish or English

Primary outcomes:
measure: Number of Patients With 1 or More Emergency Department Visits Per Quarter
timeFrame: Baseline injury admission to 12-months post-injury follow-up
measure: Change in Posttraumatic Concern Severity
timeFrame: Baseline injury admission and 1-, 3-, 6-, 9- and 12-months post-injury follow-up
measure: Change in Posttraumatic Stress Disorder (PTSD) Symptoms
timeFrame: Baseline injury admission and 1-, 3-, 6-, 9- and 12-months post-injury follow-up
measure: Change in Functional Status
timeFrame: Baseline injury admission and 1-, 3-, 6-, 9- and 12-months post-injury follow-up
Secondary outcomes:
Other outcomes:
Locations:
city: Seattle
country: United States
facility: University of Washington Harborview Level I Trauma Center
state: Washington
Study officials:
References:
citation: Scheuer H, Engstrom A, Thomas P, Moodliar R, Moloney K, Walen ML, Johnson P, Seo S, Vaziri N, Martinez A, Maier R, Russo J, Sieber S, Anziano P, Anderson K, Bulger E, Whiteside L, Heagerty P, Palinkas L, Zatzick D. A comparative effectiveness trial of an information technology enhanced peer-integrated collaborative care intervention versus enhanced usual care for US trauma care systems: Clinical study protocol. Contemp Clin Trials. 2020 Apr;91:105970. doi: 10.1016/j.cct.2020.105970. Epub 2020 Feb 29.