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Sponsors and Collaborators: |
National Institute on Aging (NIA) UCLA Resource Centers for Minority Aging Research/Center for Health Improvement of Minority Elderly (RCMAR/CHIME) |
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Information provided by: | National Institute on Aging (NIA) |
ClinicalTrials.gov Identifier: | NCT00570427 |
The purpose of this study is to improve access to quality depression care for older, low-income, minority adults in public sector health care. The study will examine current depression care in a public sector geriatric clinic that serves mostly Spanish-speaking Latinos and pilot study assessments and treatments in order to lay the groundwork for a large study of quality improvement for depressed older minorities
Condition | Intervention |
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Depression |
Behavioral: Problem Solving Therapy (PST) Behavioral: Medication Management |
Study Type: | Interventional |
Study Design: | Treatment, Non-Randomized, Open Label, Uncontrolled, Single Group Assignment, Efficacy Study |
Official Title: | Improving Depression Treatment for Older Minority Adults |
Estimated Enrollment: | 30 |
Study Start Date: | February 2007 |
Estimated Study Completion Date: | June 2008 |
Estimated Primary Completion Date: | June 2008 (Final data collection date for primary outcome measure) |
Arms | Assigned Interventions |
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1.: Experimental
All participants
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Behavioral: Problem Solving Therapy (PST)
Counseling
Behavioral: Medication Management
If a participant chooses to receive antidepressant medication while in the study, a depression care specialist works with the participant's usual primary care provider to initiate an appropriate prescription and to follow-up with side effects, adherence, efficacy, etc. on a monthly or biweekly basis.
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Depressive disorders affect 5-10% of older primary care patients, although rates may be higher among Latinos, especially among immigrants and those less acculturated. Late-life depression may be chronic and recurrent and results in significant morbidity and mortality. Despite a growing evidence base for the treatment of geriatric depression, only half of depressed older adults receive mental health care; fewer than 10% receive specialty services. Treatment rates are even lower for low-income, ethnic minorities who may be more ill and disabled, may lack adequate insurance and have different treatment preferences, and who frequently face barriers to accessing care. Recent quality improvement interventions for geriatric depression have targeted primary care, the location where older patients and ethnic minorities are most likely to receive mental health services. A recent multi-site, randomized trial of collaborative care for geriatric depression in primary care offered patients their choice of treatments, including antidepressant medication or 6-8 sessions of a structured psychotherapy. Although the intervention had few cultural accommodations, both processes and outcomes of care improved for depressed older minorities. However, because the study only included Latinos who were English-speaking and mostly high school graduates, these results may not generalize to a large proportion of ethnic minorities.
This study first examines current rates of depression and patterns of depression treatment in a public-sector geriatric clinic that serves mostly Spanish-speaking Latinos. Then depressed patients are identified and their depression treatment preferences and barriers to care are assessed. Patients are enrolled in a 6-month patient-centered, evidence-based intervention, and they, family members, and clinic medical providers are interviewed at program end to assess the feasibility, acceptability, and possible effectiveness of the intervention.
Ages Eligible for Study: | 60 Years and older |
Genders Eligible for Study: | Both |
Accepts Healthy Volunteers: | No |
Inclusion Criteria:
Exclusion Criteria:
Contact: Jennifer M. Green, MSW | 323-442-3999 | jennifer.m.green@usc.edu |
United States, California | |
LAC+USC Medical Center Geriatric Clinic | Recruiting |
Los Angeles, California, United States, 90033 | |
Contact: Jennifer M. Green, MSW 323-442-3999 jennifer.m.green@usc.edu | |
Principal Investigator: Isabel T. Lagomasino, MD, MSHS | |
Sub-Investigator: Sarita Mohanty, MD, MPH |
Principal Investigator: | Isabel T. Lagomasino, MD MSHS | Department of Psychiatry, Keck School of Medicine, University of Southern California |
Responsible Party: | Keck School of Medicine, University of Southern California ( Isabel T. Lagomasino, MD MSHS ) |
Study ID Numbers: | AG0091, 5P30 AG021684, 1557 G GD102 |
Study First Received: | December 7, 2007 |
Last Updated: | February 28, 2008 |
ClinicalTrials.gov Identifier: | NCT00570427 |
Health Authority: | United States: Federal Government |
psychotherapy behavior therapy counseling aging medically underserved population |
Depression Mental Disorders Mood Disorders Depressive Disorder Behavioral Symptoms |