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Sponsors and Collaborators: |
National Institute of Mental Health (NIMH) Dartmouth-Hitchcock Medical Center |
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Information provided by: | National Institute of Mental Health (NIMH) |
ClinicalTrials.gov Identifier: | NCT00169052 |
This study will evaluate the effectiveness of a health management and supported rehabilitation intervention in treating serious mental illnesses in older people.
Condition | Intervention |
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Schizophrenia Schizoaffective Disorder Bipolar Disorder Major Depression |
Behavioral: Health Care Management and Supported Rehabilitation |
Study Type: | Interventional |
Study Design: | Treatment, Randomized, Single Blind, Active Control, Single Group Assignment, Efficacy Study |
Official Title: | Rehabilitation and Health Care for Elderly With SMI |
Estimated Enrollment: | 180 |
Study Start Date: | September 2001 |
Estimated Study Completion Date: | August 2006 |
This randomized, controlled study will evaluate the effectiveness of a health management (HM) and supported rehabilitation (SR) intervention for 180 older persons (age 50+) with serious mental illness. We will address the following specific aims and hypotheses:
Specific Aim 1- To compare the effectiveness of SR/HM to UC in improving independent living skills and health management. We hypothesize that compared to older individuals with SMI receiving UC, individuals receiving SR/HM will have better independent living skills and health management, evidenced by:
Specific Aim 2- To compare the effectiveness of SR/HM to UC in decreasing the use of high-cost acute and long-term institution-based services. We hypothesize that compared to older individuals with SMI receiving UC, individuals receiving SR/HM will use fewer high cost services, including emergency room visits, acute hospitalizations, and nursing home care. In addition, the reduced use of high cost institution-based services will be associated with better independent living skills and health management practices resulting from the SR/HM intervention.
We will also evaluate the following secondary, exploratory hypotheses:
In addition, we will describe outpatient service utilization for SR/HM and UC models within each study site in order to present a more comprehensive account of services used by study participants.
Little is known about how to provide effective rehabilitation and health management services to older persons with serious mental illness (SMI) to decrease the use of high-cost institution-based services. To address this need, we developed a supported rehabilitation and health management (SR/HM) intervention for older persons with SMI that addresses functioning in two areas essential for preventing hospitalizations and long-term institutional care: (1) enhanced independent living skills and (2) improved health management. The supported rehabilitation (SR) component consists of skills training aimed at improving competence in everyday functioning, including community living skills and social skills. The health management (HM) component consists of training in health management skills and health case management by nurses who monitor and facilitate routine preventive and acute health care. Results from a pilot study indicate that SR/HM is effective in improving independent living skills and health management for older persons with SMI.
The aims of this study are to test the effectiveness of the SR/HM intervention in improving the functioning and health care of older persons with SMI and in reducing the use of high cost, acute and long-term institution-based care. The proposed research will compare the SR/HM intervention to usual care (UC) in a randomized, controlled study of 180 individuals age 60 and older with SMI living in the community.
Ages Eligible for Study: | 50 Years and older |
Genders Eligible for Study: | Female |
Inclusion Criteria:
Exclusion Criteria:
United States, Massachusetts | |
Freedom Trail Clinic | |
Boston, Massachusetts, United States, 02114 | |
Massachusetts Mental Health Center | |
Boston, Massachusetts, United States, 02115 | |
United States, New Hampshire | |
Community Council of Nashua | |
Nashua, New Hampshire, United States, 03060 |
Principal Investigator: | Stephen J Bartels, MD | Dartmouth |
Study ID Numbers: | R01 MH62324, DSIR 82-SEMS |
Study First Received: | September 11, 2005 |
Last Updated: | February 22, 2006 |
ClinicalTrials.gov Identifier: | NCT00169052 |
Health Authority: | United States: Federal Government |
geriatric, older serious mental illness SMI |
Schizophrenia Affective Disorders, Psychotic Depression Mental Disorders Bipolar Disorder Mood Disorders |
Psychotic Disorders Depressive Disorder, Major Depressive Disorder Schizophrenia and Disorders with Psychotic Features Behavioral Symptoms |
Pathologic Processes Disease |