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Clinical Trial Details — Status: Recruiting

Administrative data

NCT number NCT05353452
Other study ID # IRB00084191
Secondary ID
Status Recruiting
Phase N/A
First received
Last updated
Start date April 30, 2023
Est. completion date July 2025

Study information

Verified date March 2024
Source Wake Forest University Health Sciences
Contact Heidi M. Munger Clary, MD, MPH
Phone 336-716-7110
Email hmungerc@wakehealth.edu
Is FDA regulated No
Health authority
Study type Interventional

Clinical Trial Summary

The purpose of this research is to evaluate a 6 month change in quality of life in subjects who receive collaborative care calls compared to those subjects who receive usual neurology care. This is a 2-site trial comparing a 24 week neurology-based collaborative care program to usual neurology care among a total of 60 adults with post-traumatic epilepsy.


Description:

The study will compare collaborative care versus usual care among N=60 adults with post-traumatic epilepsy and anxiety and/or depression symptoms in Veterans Administration (N=20) and civilian university (N=40) settings at the Salisbury VA and Atrium Health Wake Forest Baptist Health (AHWFB) Neurology. This single-blind study will evaluate effectiveness and implementation of a remotely-delivered, 24-week team-delivered collaborative care intervention, with features adapted from VA Primary Care Mental Health Integration and Whole Health, as well as an existing Family Medicine Collaborative Care Program at AHWFB.


Recruitment information / eligibility

Status Recruiting
Enrollment 60
Est. completion date July 2025
Est. primary completion date July 2025
Accepts healthy volunteers No
Gender All
Age group 18 Years and older
Eligibility Inclusion Criteria: - Provision of signed and dated informed consent form - Stated willingness to comply with all study procedures - Diagnosis of post-traumatic epilepsy, defined by the following: 1. Epilepsy diagnosis based on neurology clinician impression of diagnosis or electroencephalogram (EEG) findings (EEG findings: presence of interictal epileptiform discharges on EEG or ictal EEG recording of seizure definitively documenting epilepsy diagnosis) 2. History of at least mild traumatic brain injury based on the MIRECC (Mental Illness Research, Education, and Clinical Center) TBI (Traumatic Brain Injury) screening instrument or verified TBI history based on MIRECC research database 3. TBI pre-dated onset of epilepsy (NINDS post-traumatic epilepsy screening form) - Anxiety or depression symptoms--Generalized Anxiety Disorder scale (GAD-7) =8 or Neurological Disorders Depression Inventory for Epilepsy (NDDI-E) >13 - Receiving clinical neurological care at one of the study sites Exclusion Criteria: - Active ongoing treatment by a psychiatrist without the potential to benefit from additional collaborative care for anxiety or depression in the judgement of the investigators - Active suicidal ideation - History of past suicide attempt - Unstable drug or alcohol abuse - Unstable or progressive comorbid medical condition - Current participation in another treatment or intervention study - Cognitive limitations precluding completion of anxiety and depression self-report instruments on paper, electronically, or by interview.

Study Design


Related Conditions & MeSH terms


Intervention

Behavioral:
Neurology Based Collaborative Care
Twenty-four week, evidence-based remote collaborative care model initiated around the time of a neurology visit. The collaborative care team roles include the care manager, psychiatrist, and psychologist/social worker who interact with the patient participant and the patient's neurologist.
SOC Neurological care
Usual neurology care means ongoing, epilepsy provider-recommended clinic visits, prescriptions, testing and referrals from their epilepsy provider. Mental health referrals or prescribing of antidepressants may potentially occur in this group; these types of interventions will be tracked at outcome assessments.

Locations

Country Name City State
United States Atrium Health Wake Forest Baptist Winston-Salem North Carolina

Sponsors (1)

Lead Sponsor Collaborator
Wake Forest University Health Sciences

Country where clinical trial is conducted

United States, 

Outcome

Type Measure Description Time frame Safety issue
Other Feasibility of Intervention Measure (FIM)-Subject Perspective Questionnaire to help determine feasibility of collaborative care from participants' perspectives. Score ranges from 5 to 20, with higher score indicating greater feasibility. Baseline and Month 3
Other FIM-Neurologist Perspective Questionnaire to help determine feasibility of collaborative care from neurologists' perspectives. Score ranges from 5 to 20, with higher score indicating greater feasibility. Baseline and Month 3
Other Acceptability of Intervention Measure (AIM)-Subject Perspective Questionnaire to help determine acceptability of collaborative care from participants' perspectives. Score ranges from 5 to 20, with higher score indicating greater acceptability. Baseline and Month 3
Other AIM-Neurologist Perspective Questionnaire to help determine acceptability of collaborative care from neurologists' perspectives. Score ranges from 5 to 20, with higher score indicating greater acceptability. Baseline and Month 3
Other Intervention Appropriateness Measure (IAM)-Subject Perspective Questionnaire to help determine appropriateness of collaborative care from participants' perspectives. Score ranges from 5 to 20, with higher s indicating greater appropriateness. Baseline and Month 3
Other IAM-Neurologist Perspective Questionnaire to help determine appropriateness of collaborative care from neurologists' perspectives. Score ranges from 5 to 20, with higher score indicating greater appropriateness. Baseline and Month 3
Other Proportion of participants who attend at least 50% of Scheduled Calls Pertains only to participants randomized to collaborative care intervention Week 12 and Week 24
Other Individual Participant Collaborative Care Call Attendance Percentage Week 12 and Week 24
Other Seizure Frequency Number of seizures experienced by participants Baseline, Month 3, and Month 6
Other Change in BDI-II Score Depression symptom questionnaire-score ranges from 0-61, with higher score indicating more severe depression symptoms. From Baseline through Month 3
Other Change in BAI Score Anxiety symptom questionnaire- score ranges from 0-61, with higher score indicating more severe anxiety symptoms. From Baseline through Month 3
Other Change in Epilepsy specific QOLIE-31 Score Score ranges from 0-100 with higher scores indicating better epilepsy-specific quality of life. From Baseline through Month 3
Other Emotional Subscale-Change in QOLIE-31 Score This is a clinically meaningful patient reported outcome measure that was demonstrated to improve in collaborative care efficacy trials in distinct patient groups (including with various different types of medical illness) Score ranges from 0-100 with higher score indicating better quality of life. Baseline through Month 3
Other Change in Neurological Disorders Depression Inventory-Epilepsy (NDDI-E) Depression symptom questionnaire specifically for those with epilepsy-score ranges from 6 to 24, with a score >15 indicating presence of a likely major depressive episode. From Baseline through Month 6
Other Change in Mini International Psychiatric Interview (MINI) Validated diagnostic interview for Diagnostic and Statistical Manual of Mental Disorders Fifth Edition (DSM-V) psychiatric diagnoses. The instrument indicates whether a current diagnosis of a DSM-V mood or anxiety disorder is present. This outcome will assess for change in presence of a current anxiety or depressive disorder at 6-months compared to baseline. From Baseline through Month 6
Other Change in Generic Quality of Life-SF-36 This instrument is composed of 8 subscales, each calculated separately on a scale of 0-100, with higher score indicating better generic health-related quality of life for that subscale. This exploratory outcome pertains to the following subscales: Physical Functioning, Role-Physical, Bodily Pain, General Health, Vitality, Social Functioning. From Baseline through Month 6
Other Change in Liverpool Seizure Severity Scale (LSSS) Seizure severity questionnaire- score ranges from 0 to 100, with higher score indicating increased seizure severity. From Baseline through Month 6
Other Prescription Adherence Collected via review of pharmacy refills--number expected divided by number taken. Month 6
Other Change in Liverpool Adverse Effect Profile (LAEP) Adverse effect questionnaire-score ranges from 19 to 76, with higher score indicating greater burden of adverse effects. From Baseline through Month 6
Other Change in Generalized Anxiety Disorders- 7(GAD-7) Score Questionnaire measuring anxiety symptoms-score ranges from 0 to 21, with higher score indicating increased anxiety symptoms. From Baseline through month 3, From Baseline through month 6
Other Change in Patient Health Questionnaire-9 (PHQ-9) Score Score ranges from 0 to 27, with higher score indicating increased depression symptoms. From Baseline through month 3, From Baseline through month 6
Other Emergency Department (ED)/Hospitalization Visits Number of hospitalizations or visits to ED. From baseline through Month 6
Primary Emotional Subscale-Change in Quality of Life in Epilepsy-31(QOLIE-31) This is a clinically meaningful patient reported outcome measure that was demonstrated to improve in collaborative care efficacy trials in distinct patient groups (including with various different types of medical illness) Score ranges from 0-100 with higher score indicating better quality of life Baseline through Month 6
Secondary Subject Adherence to Intervention Proportion of intervention arm participants who attend 50% or more of the care management calls in the first 12 weeks of the intervention. Week 12
Secondary Change in Epilepsy specific QOLIE-31 score Score ranges from 0-100 with higher score indicating better epilepsy-specific quality of life. Baseline through Month 6
Secondary Change in Beck Depression Inventory-II (BDI-II) score Depression symptom questionnaire-score ranges from 0-61, with higher score indicating more severe depression symptoms. From baseline through Month 6
Secondary Change in Beck Anxiety Index (BAI) score Anxiety symptom questionnaire-score ranges from 0-61, with higher score indicating more severe anxiety symptoms. From baseline through Month 6
See also
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Terminated NCT00566046 - Prevention of Post-traumatic Seizures With Levetiracetam Phase 3
Recruiting NCT03999164 - Imaging of Neuro-Inflammation and the Risk for Post-Traumatic Epilepsy Phase 1