Clinical trial NCT00777205: Improving Depression Management Through Peer Support
Official title: Improving Depression Management Through Peer Support
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: NA
Conditions: Depression
Keywords: Peer Support
Quality of Life
Telephone
Lead sponsor: VA Office of Research and Development
Sponsor class: FED
First posted: 2008-10-22
Enrollment: 443
Sex: ALL
Minimum age (years): 18
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Allocation: RANDOMIZED
Intervention model: PARALLEL
Primary purpose: HEALTH_SERVICES_RESEARCH

Brief summary: We conducted a randomized controlled trial (RCT) that compared the effectiveness of a telephone delivered, recovery focused, peer-support intervention to enhanced usual care for VA patients with depression.

Detailed description: Peer-support interventions have been recommended by prestigious national task forces and incorporated into the VA Comprehensive Mental Health Strategic Plan. Patients who cope with longer term depressive symptoms may benefit from these interventions.This study examines the effectiveness of a feasible, scalable mutual peer-support intervention for VA patients in depression treatment and will inform leaders who are considering implementing peer-support initiatives.

In this study, each study participant (a veteran in treatment for depression) was matched with another participating veteran and the pairs were randomized to enhanced usual care or to the telephone based peer-support intervention (DIAL-UP). All study participants received usual care plus written materials outlining depression self-management strategies, behavioral activation, and recovery.

DIAL-UP participants also received: a) a peer-support manual that outlined peer support principles and provided peer discussion topics and b) access to a specialized telephone platform that permited free calls to their partners, ready access to mental health staff for back-up and advice, and recorded tips on depression management. Patients were encouraged to call their partners at least once per week during the 6-month intervention period. Patient outcomes were assessed at 3, 6, and 12 months following enrollment.

Eligibility criteria: Inclusion Criteria:

* currently in treatment at Ann Arbor, Detroit, Battle Creek, or Saginaw VA or their associated community based outpatient clinics
* not receiving formal mental health services or regularly attending mutual self-help programs outside of the VA
* diagnosis of a depressive disorder in the last 24 months that is confirmed by the relevant clinician
* being seen less than bi-weekly by clinicians for psychiatric or substance use disorders
* past trial of psychotherapy and/or antidepressant trial
* have a current PHQ-9 scores \> 10 or WSAS scores \> 10
* have stable access to and ability to communicate by telephone

Exclusion Criteria:

* diagnosis of schizophrenia, schizoaffective disorder, MDD with psychotic features, or Bipolar I in the past 24 months. Diagnosis of active substance dependence in the past 12 months or substance abuse in the last 6 months
* an immediate risk of suicide, requiring hospitalization or urgent evaluation
* clinician assessment that participation in the study could have an adverse impact on the patient or his/her partner.

Primary outcomes:
measure: Change in Functional Status-Mental Health (MCS) Over 12 Month Period
timeFrame: Change over study period
measure: Change in Functional Status-Physical Health (PCS) Over 12 Month Period
timeFrame: Change over study period
measure: Quality of Life
timeFrame: Change over study period
measure: Depression Symptoms
timeFrame: Change over study period
measure: Recovery Orientation
timeFrame: Change over study period
Secondary outcomes:
Other outcomes:
Locations:
city: Ann Arbor
country: United States
facility: VA Ann Arbor Healthcare System, Ann Arbor, MI
state: Michigan
city: Battle Creek
country: United States
facility: VA Medical Center, Battle Creek
state: Michigan
city: Detroit
country: United States
facility: John D. Dingell VA Medical Center, Detroit, MI
state: Michigan
city: Saginaw
country: United States
facility: Aleda E. Lutz VA Medical Center
state: Michigan
Study officials:
affiliation: VA Ann Arbor Healthcare System, Ann Arbor, MI
name: Marcia T. Valenstein, MD AB
role: PRINCIPAL_INVESTIGATOR
References:
citation: Pfeiffer PN, Heisler M, Piette JD, Rogers MA, Valenstein M. Efficacy of peer support interventions for depression: a meta-analysis. Gen Hosp Psychiatry. 2011 Jan-Feb;33(1):29-36. doi: 10.1016/j.genhosppsych.2010.10.002. Epub 2010 Nov 13.
citation: Pfeiffer PN, Brandfon S, Garcia E, Duffy S, Ganoczy D, Myra Kim H, Valenstein M. Predictors of suicidal ideation among depressed Veterans and the interpersonal theory of suicide. J Affect Disord. 2014 Jan;152-154:277-81. doi: 10.1016/j.jad.2013.09.025. Epub 2013 Oct 4.