Investigating the Effectiveness of Telepsychiatry for Treating Major Depression in a Chinese American Nursing Home

• Sponsor: Massachusetts General Hospital (Other)
• Overall Status: Completed
• CT.gov ID: NCT00505518
• Collaborator: (none)
• Enrollment: 9
• Locations: 2
• Duration (Months): 14
• Patients Per Site: 4.5
• Patients Per Site Per Month: 0.3

Study Details

Study Description

Brief Summary

The current use of telepsychiatry, or psychiatric care using videoconferencing, is very limited. The present study investigates the use of this method with a depressed Chinese American population in a nursing home. It is believed that this population can benefit from telepsychiatric treatment when used in collaboration with the primary care they receive in the nursing home.

Condition or Disease	Intervention/Treatment	Phase
Major Depressive Disorder	Drug: Psychotropic medication (at discretion of psychiatrist); Behavioral: Collaborative psychiatric and primary medical care	N/A

Detailed Description

Individuals at the South Cove Manor nursing home will be referred to this study if they are experiencing depression. After meeting with the Principal Investigator (a psychiatrist), he will collaborate with the primary care physician and the nursing home staff to establish a treatment plan for the patient. Videoconferencing will be used by the P.I. for regular psychiatric visits with the patient as well as meetings with the nursing home staff to coordinate care for the patient. After collaboration between the two groups, treatment suggestions will be given to the patient's primary care physician (PCP) to implement in the primary care setting. The patient's symptomology, mood, satisfaction of life and side effects of medication will be recorded regularly to measure the effects of treatment for analysis.

Study Design

• Study Type: Interventional
• Actual Enrollment: 9 participants
• Allocation: N/A
• Intervention Model: Single Group Assignment
• Masking: None (Open Label)
• Primary Purpose: Treatment
• Official Title: Feasibility and Effectiveness of Telepsychiatry for Collaborative Management of Chinese Americans With Psychiatric Disorders in a Nursing Home
• Study Start Date: Sep 1, 2006
• Actual Primary Completion Date: Nov 1, 2007
• Actual Study Completion Date: Nov 1, 2007

Outcome Measures

Primary Outcome Measures

1. Change in Mean Scores on Clinical Global Impressions [Baseline, 30 days or 60 days (length depended on clinical needs of patients)]

   Minimum score - 1 (better outcome) Maximum score - 7 (worse outcome)

2. Patient/Family Telepsychiatry Service Satisfaction Survey [30 days or 60 days (length depended on clinical needs of patients)]

   Patients' (or their family members' for those who had severe cognitive deficits) satisfaction with the telepsychiatry services were surveyed using a satisfaction questionnaire specifically designed for this study. The satisfaction questionnaire is a scale with three choices: "not satisfied", "satisfied", and "highly satisfied."

3. Nurse Telepsychiatry Services Satisfaction Questionnaire [30 days or 60 days (length depended on clinical needs of patients)]

   The charge nurse's satisfaction with the telepsychiatry services were surveyed using a satisfaction questionnaire specifically designed for this study. The satisfaction questionnaire is a scale with three choices: "not satisfied", "satisfied", and "highly satisfied."

Eligibility Criteria

Criteria

• Ages Eligible for Study: 18 Years and Older
• Sexes Eligible for Study: All
• Accepts Healthy Volunteers: No

Inclusion Criteria:

• Clinical diagnosis of Major Depressive Disorder

• Patient at South Cove Manor Nursing Home

• Referred by nursing staff for psychiatric consultation

Exclusion Criteria:

• Not competent to participate in psychiatric interviews

Contacts and Locations

Locations

	Site	City	State	Country	Postal Code
1	Depression and Clinical Research Program at Massachusetts General Hospital	Boston	Massachusetts	United States	02114
2	South Cove Manor	Boston	Massachusetts	United States	02118

Sponsors and Collaborators

• Massachusetts General Hospital

Investigators

• Principal Investigator: Albert Yeung, S., M.D., Massachusetts General Hospital

Study Documents (Full-Text)

None provided.

More Information

Publications

None provided.

• Responsible Party: Albert Yeung, Principal Investigator, Massachusetts General Hospital
• ClinicalTrials.gov Identifier: NCT00505518
• Other Study ID Numbers: 2006-P-001508
• First Posted: Jul 23, 2007
• Last Update Posted: Sep 17, 2013
• Last Verified: Jul 1, 2013

• Keywords provided by Albert Yeung, Principal Investigator, Massachusetts General Hospital: Major Depressive Disorder; Telepsychiatry; Chinese American; Nursing Home
• Additional relevant MeSH terms: Depressive Disorder; Depression; Depressive Disorder, Major; Psychotropic Drugs

Study Results

Participant Flow

Recruitment Details	The study was conducted from September 2006 to November 2007 as a collaborative project between Massachusetts General Hospital and South Cove Manor Nursing Home, which is located in Boston's Chinatown.

Arm/Group Title	Telepsychiatry Treatment
Arm/Group Description	Patients in the telepsychiatry treatment group will videoconference the P.I. for regular psychiatric visits in addition to meeting with nursing home staff. Treatment suggestions will be provided to the patient's primary care physician to be implemented.
Period Title: Overall Study
STARTED	9
COMPLETED	9
NOT COMPLETED	0

Baseline Characteristics

Arm/Group Title	Telepsychiatry Treatment
Arm/Group Description	Patients in the telepsychiatry treatment group will videoconference the P.I. for regular psychiatric visits in addition to meeting with nursing home staff. Treatment suggestions will be provided to the patient's primary care physician to be implemented.
Overall Participants	9
Age (Count of Participants)
<=18 years	0 0%
Between 18 and 65 years	1 11.1%
>=65 years	8 88.9%
Age (years) [Mean (Standard Deviation) ]
Mean (Standard Deviation) [years]	77.33 (11)
Sex: Female, Male (Count of Participants)
Female	8 88.9%
Male	1 11.1%
Region of Enrollment (participants) [Number]
United States	9 100%

Outcome Measures

1. Primary Outcome

Title	Change in Mean Scores on Clinical Global Impressions
Description	Minimum score - 1 (better outcome) Maximum score - 7 (worse outcome)
Time Frame	Baseline, 30 days or 60 days (length depended on clinical needs of patients)

Outcome Measure Data

Analysis Population Description

[Not Specified]

Arm/Group Title	Telepsychiatry
Arm/Group Description	Telepsychiatry-based follow up visits with psychiatrist.
Measure Participants	9
Mean (Standard Deviation) [units on a scale]	-2.1 (0.38)

2. Primary Outcome

Title	Patient/Family Telepsychiatry Service Satisfaction Survey
Description	Patients' (or their family members' for those who had severe cognitive deficits) satisfaction with the telepsychiatry services were surveyed using a satisfaction questionnaire specifically designed for this study. The satisfaction questionnaire is a scale with three choices: "not satisfied", "satisfied", and "highly satisfied."
Time Frame	30 days or 60 days (length depended on clinical needs of patients)

Outcome Measure Data

Analysis Population Description

[Not Specified]

Arm/Group Title	Telepsychiatry
Arm/Group Description	Telepsychiatry-based follow up visits with psychiatrist.
Measure Participants	9
Highly not satisfied	0 0%
Not satisfied	0 0%
Satisfied	1 11.1%
Highly satisfied	7 77.8%
No response	1 11.1%

3. Primary Outcome

Title	Nurse Telepsychiatry Services Satisfaction Questionnaire
Description	The charge nurse's satisfaction with the telepsychiatry services were surveyed using a satisfaction questionnaire specifically designed for this study. The satisfaction questionnaire is a scale with three choices: "not satisfied", "satisfied", and "highly satisfied."
Time Frame	30 days or 60 days (length depended on clinical needs of patients)

Outcome Measure Data

Analysis Population Description

[Not Specified]

Arm/Group Title	Telepsychiatry
Arm/Group Description	Telepsychiatry-based follow up visits with psychiatrist.
Measure Participants	9
Highly Satisfied	8 88.9%
Satisfied	1 11.1%
Not Satisfied	0 0%

Adverse Events

Arm/Group Title	Telepsychiatry Treatment
Arm/Group Description	Patients in the telepsychiatry treatment group will videoconference the P.I. for regular psychiatric visits in addition to meeting with nursing home staff. Treatment suggestions will be provided to the patient's primary care physician to be implemented.
All Cause Mortality
	Telepsychiatry Treatment
	Affected / at Risk (%)	# Events
Total	/ (NaN)
Serious Adverse Events
	Telepsychiatry Treatment
	Affected / at Risk (%)	# Events
Total	0/9 (0%)
Other (Not Including Serious) Adverse Events
	Telepsychiatry Treatment
	Affected / at Risk (%)	# Events
Total	0/9 (0%)

Limitations/Caveats

Many subjects in the study suffered from dementia and psychotic symptoms, thus their responses may not be reliable.

More Information

Certain Agreements

All Principal Investigators ARE employed by the organization sponsoring the study.

There is NOT an agreement between Principal Investigators and the Sponsor (or its agents) that restricts the PI's rights to discuss or publish trial results after the trial is completed.