Depression Clinical Trial
— COPD_HSRGOfficial title:
"Consultation Liaison and Integrated Care for COPD Patients With Psychiatric Co-Morbidity"
Verified date | September 2018 |
Source | National University, Singapore |
Contact | n/a |
Is FDA regulated | No |
Health authority | |
Study type | Interventional |
Chronic obstructive pulmonary disease (COPD) stands out among chronic diseases with its high
and rising prevalence and mortality, poor quality of life, high re-hospitalization rates and
societal burden of care. Current therapeutic and management practices are generally met with
limited success. Research in recent years have highlighted the high level of psychiatric
co-morbidity in COPD patients, and the major prognostic significance of anxiety/depression in
COPD outcomes such as re-hospitalization, smoking cessation, quality of life, and survival.
This suggests that addressing psychiatric and psycho-social aspects of care prominent in COPD
patients may have strongly positive impact on outcomes, but the available evidence of
effectiveness is limited.
The primary aim of the proposed research is to evaluate the effectiveness of a holistic
disease management paradigm of psychiatric liaison consultation (CL) that integrates
psychiatric and respiratory care to improve outcomes for COPD patients. This integrated
psychiatric consultation liaison (IPCL) management paradigm includes the routine screening
and structured collaborative care of anxiety and major depressive symptoms and
depressive/anxiety disorder in COPD patients. We postulate that the IPCL care paradigm would
reduce mood symptoms, increase smoking quit rates, reduce symptom burden and functional
disability, and improve quality of life, while reducing rehospitalization, emergency
department (ED) and unscheduled physician visits. A secondary aim is to evaluate its cost
effectiveness by concurrently collecting resource utilization data.
Status | Completed |
Enrollment | 295 |
Est. completion date | December 2017 |
Est. primary completion date | December 2017 |
Accepts healthy volunteers | No |
Gender | All |
Age group | 55 Years to 90 Years |
Eligibility |
Inclusion Criteria: - Inpatients and specialist outpatients from: NUHS, SGH, CGH, SLH and AH. - Clinical diagnosis of chronic obstructive pulmonary disease (COPD) based on history, physical examination, spirometry, measurement of arterial blood gases, and chest radiographs, that meets the criteria for COPD as defined in the Global Initiative for Chronic Obstructive Lung Disease (GOLD). - COPD patients include cases of all grades of severity, and co-morbidity, without restriction. - Participants provide written informed consent. Exclusion Criteria: - Known diagnosis of a psychiatric disorder that is under treatment. - Terminally ill COPD patients who are unable to complete baseline assessments. |
Country | Name | City | State |
---|---|---|---|
Singapore | National University Hospital System | Singapore |
Lead Sponsor | Collaborator |
---|---|
National University, Singapore | Alexandra Hospital, Singapore, Changi General Hospital, National University Hospital, Singapore, Singapore General Hospital, St Luke's Hospital, Singapore |
Singapore,
Cao Z, Ong KC, Eng P, Tan WC, Ng TP. Frequent hospital readmissions for acute exacerbation of COPD and their associated factors. Respirology. 2006 Mar;11(2):188-95. — View Citation
Ng TP, Niti M, Fones C, Yap KB, Tan WC. Co-morbid association of depression and COPD: a population-based study. Respir Med. 2009 Jun;103(6):895-901. doi: 10.1016/j.rmed.2008.12.010. Epub 2009 Jan 10. — View Citation
Ng TP, Niti M, Tan WC, Cao Z, Ong KC, Eng P. Depressive symptoms and chronic obstructive pulmonary disease: effect on mortality, hospital readmission, symptom burden, functional status, and quality of life. Arch Intern Med. 2007 Jan 8;167(1):60-7. — View Citation
Ng TP, Niti M, Tan WC. Trends and ethnic differences in COPD hospitalization and mortality in Singapore. COPD. 2004 Apr;1(1):5-11. — View Citation
Niti M, Ng TP, Kua EH, Ho RC, Tan CH. Depression and chronic medical illnesses in Asian older adults: the role of subjective health and functional status. Int J Geriatr Psychiatry. 2007 Nov;22(11):1087-94. — View Citation
Type | Measure | Description | Time frame | Safety issue |
---|---|---|---|---|
Primary | HADS score | Anxiety and depression symptoms and diagnosis | over 12 months | |
Secondary | Resource use and direct costs of care | Resource use include inpatient service use (No. of times hospitalized and total days in hospital) , outpatient service use (physician visits consisting of GP visits and specialist visits,) and medication use( usage of any or specific drug classes)and costs for resource use over 12 months | over 12 months |
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