Clinical trial NCT03191929: Depression Screening in Primary Care: Using HIT for Patients With Limited English
Official title: Depression Screening in Primary Care: Using HIT for Patients With Limited English
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: NA
Conditions: Depression
Post-Traumatic Stress Disorder
Keywords: Depression
Post-traumatic Stress Disorder
Health Information Technology (HIT)
Primary Care Provider
Mental Health Screening
Lead sponsor: University of California, Irvine
Sponsor class: OTHER
First posted: 2017-06-19
Enrollment: 410
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 assessed the potential of Health Information Technology (HIT) to improve the screening, diagnosis, and treatment of depression and post-traumatic stress among LEP Southeast Asians. Should this intervention be found to be effective, the principles of the HIT technology could be easily adapted for screening in other languages to increase the recognition and treatment of depression and PTSD in primary care settings.

Detailed description: The prevalence of depression in primary care is high. Primary care physicians serve as the initial point of contact for most patients with depression, yet it is estimated that only about half of the depressed patients who present for care are recognized and treated. Language barriers can further exacerbate this problem. Approximately 54 million people in the United States speak a language other than English at home and over 21 million are limited English-language proficient (LEP). Language barriers may result in less discussion about patients' mental health needs and fewer referrals to specialty mental health services. Recent advances in health information technology (HIT), however, may facilitate novel ways to screen for mental health problems among limited English proficient patients. The HIT intervention is a provider-level intervention that consists of four components: 1) web- based training for the providers; 2) multimedia electronic screening of patients for depression and PTSD; 3) immediate notification to the health care providers and integration with the patients' electronic health records (EHR); and 4) provider clinical decision support. In a randomized controlled trial in a primary care setting, we will assess the potential of a multi-component health information technology intervention to improve the screening rates, clinical detection, provider initiation of treatment, and patient outcomes for depression and post-traumatic stress disorder among LEP Southeast Asians. We will examine the usability and acceptability of this technology to patients with limited English skills and their providers. Finally, we will identify and evaluate potential facilitators and barriers to wide spread implementation and dissemination of the HIT intervention. This technology has the potential to be adapted and utilized for any group of limited English-language proficient (LEP) patients, regardless of their native language, and has the potential to be adapted for providers to aid in the recognition, diagnosis, and treatment of mental health problems in diverse primary care settings.

Eligibility criteria: Inclusion Criteria:

* Cambodian patients over age 18 were included.

Exclusion Criteria:

* Patients with severe visual/hearing impairments, major psychiatric disorders such as bipolar disorder or schizophrenia, and/or life-threatening illness, which limited their ability to consent to the study were excluded.

Primary outcomes:
measure: Appropriate clinical detection of depression and/or PTSD
timeFrame: 12 weeks
Secondary outcomes:
measure: Provider initiation of guideline mental health treatment and trauma informed care
timeFrame: 12 weeks
measure: Patient outcomes (at 12 weeks post-baseline visit) for depression and/or PTSD
timeFrame: 12 weeks
measure: Patients' evaluation of the overall quality of care
timeFrame: 12 weeks
measure: Patients' level of involvement in decision-making related to their care
timeFrame: 12 weeks
measure: Patients' trust in their provider
timeFrame: 12 weeks
measure: Patients' perceptions of being treated as an equal partner in their care
timeFrame: 12 weeks
Other outcomes:
Locations:
Study officials:
affiliation: University of California, Irvine
name: Dara H. Sorkin, Ph.D.
role: PRINCIPAL_INVESTIGATOR
References:
citation: Sorkin DH, Rizzo S, Biegler K, Sim SE, Nicholas E, Chandler M, Ngo-Metzger Q, Paigne K, Nguyen DV, Mollica R. Novel Health Information Technology to Aid Provider Recognition and Treatment of Major Depressive Disorder and Posttraumatic Stress Disorder in Primary Care. Med Care. 2019 Jun;57 Suppl 6 Suppl 2(Suppl 6 2):S190-S196. doi: 10.1097/MLR.0000000000001036.