The writeup on MedPage here;
http://www.medpagetoday.com/Cardiology/Prevention/45251?xid=nl_mpt_cardiodaily_2014-04-14&
The actual clinical trial here:
A Collaborative Care Program to Improve Treatment of Depression and Anxiety Disorders in Cardiac Patients (MOSAIC)
Purpose
For
this trial, the investigators propose a prospective trial of a
collaborative care program to identify and treat depression, generalized
anxiety disorder (GAD), and panic disorder (PD) among patients admitted
to the hospital for an acute cardiac illness (acute coronary syndrome
[ACS], congestive heart failure [CHF], or arrhythmia). Such assessment
and treatment for depression/GAD/PD will begin in the hospital, and
ongoing management will continue for six months following discharge.
The investigators
hypothesize that this model will lead to increased treatment rates,
improved mood, reduced anxiety, and improved medical outcomes in this
vulnerable population. If this model is effective, it could be
implemented clinically to provide better and more complete care to
patients hospitalized with acute cardiac illness, for whom depression
and anxiety may be a risk factor for complications and death.
This will be a two-arm,
single-blind randomized controlled trial, with one-half of patients
randomized to collaborative care and one-half randomized to the control
condition (usual care). Psychiatric treatment in the intervention arm
will be provided in concert with patients' primary care physicians
(PCPs)—with PCPs prescribing all medications—within a framework
supervised by a psychiatrist.
The investigators will
enroll patients who have any (or all) of the three included psychiatric
diagnoses to improve the utility of the intervention. The investigators
have chosen to enroll patients with several different cardiac
diagnoses. This will allow the researchers to include patients with
heterogeneous diagnoses and illness severity to determine if our
intervention is effective in a broad population of patients with heart
disease. The investigators will study an intervention targeting
depression, GAD, and PD: all three disorders are disabling and
associated with adverse cardiovascular outcomes, treatments for the
conditions are highly similar, the investigators can treat patients who
have more than one disorder, and a prior outpatient program successfully
simultaneously addressed more than one mental health condition.
The project will involve:
(1) screening patients for depression, GAD, and PD as part of usual
clinical care, (2) evaluation of positive-screen patients by a study
social work care manager, (3) a multicomponent in-hospital intervention
(for collaborative care patients) that involves patient education,
specialist-provided treatment recommendations, and a goal of in-hospital
treatment initiation, and (4), after discharge, continued phone-based
evaluation and care coordination with PCPs to provide stepwise treatment
in the collaborative care arm. The intervention has been designed to
be low-cost, low-burden, and easily generalizable to other settings.
No comments:
Post a Comment