Collaborative Care Model for Depression

Recruiting at 5 trial locations

Overseen By Irina Perreard, PhD

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: Dartmouth-Hitchcock Medical Center

Disqualifiers: Not in CoCM, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: Unknown

Duration: 3-4 months

2448 Participants Needed

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial aims to determine if incorporating patients' personal goals and concerns into their treatment approach can enhance engagement and satisfaction with depression care. Researchers will evaluate whether a special system, which includes a pre-visit questionnaire and visual dashboard, improves the experience for both patients and doctors compared to usual care. Individuals involved in Dartmouth Health’s Collaborative Care Model for depression and interested in enhancing their treatment experience might be suitable candidates. Participants will complete questionnaires before visits, and these responses will guide their care. As an unphased trial, this study provides a unique opportunity for patients to actively shape and improve their treatment experience.

Will I have to stop taking my current medications?

The trial information does not specify whether you need to stop taking your current medications.

What prior data suggests that this clinical decision support system is safe for use in collaborative care?

Research has shown that the Collaborative Care Model, particularly when combined with a Clinical Decision Support System (CDSS), is generally safe. It reduces medication errors and negative side effects.

Studies have found that using CDSS in treating depression improves patient outcomes, indicating that most individuals tolerate the treatment well. These studies have not found evidence of serious safety issues.

Overall, the collaborative care approach, especially with these enhanced systems, appears to be a safe method to improve mental health care. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about the collaborative care model for depression because it integrates a clinical decision support system (CDSS) to enhance patient care. This system includes an improved pre-visit questionnaire and a dashboard that visualizes both patient-reported and clinical information. Unlike the usual care models, this approach allows for more personalized and informed treatment decisions, potentially leading to better outcomes for patients. By streamlining data and providing clear visual insights, the CDSS empowers healthcare providers to make quicker and more accurate decisions.

What evidence suggests that the clinical decision support system is effective for improving engagement in the collaborative care model for depression?

Research has shown that combining mental health care with regular doctor visits effectively treats depression. This approach involves care managers and strong communication between patients, doctors, and mental health specialists. In this trial, participants will join one of two treatment arms. One arm will use the standard collaborative care model, while the other will incorporate a clinical decision support system (CDSS). Studies have found that a CDSS can enhance this approach. The CDSS includes tools such as improved pre-visit questionnaires and dashboards that clearly display patient information. Early results suggest these tools can increase patient involvement and satisfaction with their treatment. ^{1 2 6 7 8}

Who Is on the Research Team?

Anna Tosteson, ScD

Principal Investigator

Dartmouth College

Are You a Good Fit for This Trial?

This trial is for adult patients with anxiety or depression who are currently receiving collaborative care. It's not specified who can't join, but typically those unable to complete questionnaires or follow the study protocol might be excluded.

Inclusion Criteria

Patients enrolled in the Collaborative Care Model (CoCM) at Dartmouth Health

Exclusion Criteria

Patients not enrolled in the Collaborative Care Model (CoCM) at Dartmouth Health

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Treatment

Participants engage in the Collaborative Care Model (CoCM) with enhanced pre-visit questionnaires and a clinical decision support system to improve engagement and satisfaction.

3-4 months

Regular visits as per CoCM protocol

Follow-up

Participants are monitored for engagement and satisfaction, with assessments of communication and treatment response.

1 month

What Are the Treatments Tested in This Trial?

Interventions

• Collaborative care model
• Collaborative care model with clinical decision support system

Trial Overview The study tests if adding a clinical decision support system, which uses an enhanced questionnaire and dashboard, to collaborative care improves patient engagement and satisfaction compared to traditional collaborative care.

How Is the Trial Designed?

Group I: Clinical Decision Support System Experimental Treatment 1 Intervention

Collaborative care model, with a clinical decision support system (CDSS) which includes an enhanced pre-visit questionnaire and dashboard to visualize patient-reported information and clinical information.

Group II: Collaborative care model (usual care) Active Control 1 Intervention

Standard collaborative care model of integrated behavioral health.

Who Is Running the Clinical Trial?

Dartmouth-Hitchcock Medical Center

Lead Sponsor

Trials

548

Recruited

2,545,000+

Trustees of Dartmouth College

Lead Sponsor

Trials

32

Recruited

14,500+

National Center for Advancing Translational Sciences (NCATS)

Collaborator

Trials

394

Recruited

404,000+

Dartmouth College

Collaborator

Trials

93

Recruited

1,415,000+

Published Research Related to This Trial

In a study analyzing 1009 ICU days, 230 adverse drug events were identified in 79 patients, with the most frequent issues being hypoglycemia, prolonged activated partial thromboplastin time, and hypokalemia.

The occurrence of adverse drug events was significantly linked to higher severity of illness and increased nursing workload, indicating that patient condition and staff demands may influence the safety of drug administration in critical care settings.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Adverse drug events in intensive care units: a cross-sectional study of prevalence and risk factors. Seynaeve, S., Verbrugghe, W., Claes, B., et al.[2013]

In a study of 5,439 patients using the collaborative care model (CCM), having a follow-up contact with a care manager within four weeks significantly increased the likelihood of improvement in depression symptoms (odds ratio of 1.63).

Receiving a psychiatric consultation between weeks 8 and 12 also improved the chances of symptom improvement (odds ratio of 1.44), highlighting the importance of these care tasks in enhancing patient outcomes in depression treatment.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Unpacking Collaborative Care for Depression: Examining Two Essential Tasks for Implementation. Bao, Y., Druss, BG., Jung, HY., et al.[2023]

The study is evaluating the effectiveness and implementation of the Collaborative Behavioral Health Program (CBHP) in 11 primary care practices over a 30-month period, aiming to improve access to mental health services for depression.

It will provide insights into the barriers and facilitators of implementing the Collaborative Care Model (CoCM) and conduct economic analyses to assess the cost-effectiveness of the program, potentially benefiting both mental health outcomes and chronic health conditions.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Collaborative care for depression management in primary care: A randomized roll-out trial using a type 2 hybrid effectiveness-implementation design. Smith, JD., Fu, E., Rado, J., et al.[2022]

Collaborative care models significantly improve depression management, showing a standardized mean difference of 0.34 in depression symptoms and enhancing treatment adherence and response rates in various populations.

The systematic review of 69 studies indicates that these models not only improve clinical outcomes like remission and recovery from symptoms but also enhance patient satisfaction and quality of life, demonstrating their effectiveness across different healthcare settings.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Collaborative care to improve the management of depressive disorders: a community guide systematic review and meta-analysis. Thota, AB., Sipe, TA., Byard, GJ., et al.[2022]

Citations

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Home | SAMHSA - Substance Abuse and Mental Health ... SAMHSA leads efforts to advance behavioral health across the U.S., offering resources for mental health, substance use, and community well-being.

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Collaborative mental health care: A narrative review - PMC The Collaborative Care model is a systematic strategy for treating behavioral health conditions in primary care through the integration of care managers and ...

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A Web-Based Clinical Decision Support System for ... Depression care managers facilitate timely communication and coordination among patients, primary care providers (PCPs), and mental health ...

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Association of collaborative care intervention features with ... The INtegrating DEPrEssioN and Diabetes treatmENT (INDEPENDENT) trial tested a collaborative care model including electronic clinical decision support (CDS) ...

5. withpower.com withpower.com/trial/phase-anxiety-disorders-2-2025-ae301

Collaborative Care Model for Depression This N/A medical study run by Dartmouth-Hitchcock Medical Center is evaluating whether Collaborative care model with clinical decision support system will ...

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A Web-Based Clinical Decision Support System ... We describe the development and functionality of a decision support system for the chronic care model of depression treatment, known as ...

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Digital and Mobile Health Technology in Collaborative ... This study aims to conduct a scoping review to synthesize the evidence available on digital and mobile health technology in collaborative care settings.

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Evidence Base for Collaborative Care (CoCM) - AIMS Center ... -analyses have shown the Collaborative Care model (CoCM) to be more effective than usual care for patients with depression,