FACE-PC: Family-Centered Care for Older Adults With Depression and Chronic Medical Conditions in Primary Care

University of California San Francisco (UCSF)

Status: Completed

Conditions: Chronic Medical Conditions; Depression

Treatments: Behavioral: FACE-PC

Study type: Interventional

Funder types: Other

Identifiers

NCT03094871

17-23224

Details and patient eligibility

About

Comorbid depression and multiple medical conditions in older adults are a serious public health problem. As an important facilitator of health-related activities, families are already involved in various aspects of self-management of chronic disease in older adults. Despite the benefits they provide, informal caregiving activities currently are organized outside the medical system, which potentially creates redundant or misaligned efforts.The purpose of the mentored research is to examine the feasibility and acceptability of the FACE-PC, a theory-driven, multi- component, technology-assisted interdisciplinary team-based care model that systematically involves family in chronic disease management. It aims to optimize the patient and family's collective ability to self-manage chronic disease.

Full description

Comorbid depression and multiple medical conditions in older adults are a serious public health problem. As an important facilitator of health-related activities, families are already involved in various aspects of self-management of chronic disease in older adults. Despite the benefits they provide, informal caregiving activities currently are organized outside the medical system, which potentially creates redundant or misaligned efforts.The purpose of the mentored research is to examine the feasibility and acceptability of the FACE-PC, a theory-driven, multi- component, technology-assisted interdisciplinary team-based care model that systematically involves family in chronic disease management. It aims to optimize the patient and family's collective ability to self-manage chronic disease.

Enrollment: 60 patients

Sex: All

Ages: 60+ years old

Volunteers: Accepts Healthy Volunteers

Inclusion and exclusion criteria

Inclusion Criteria for Patient:

• 60 years of age or older
• Receives primary care
• PHQ-9 score ≥ 5
• Must have at least one medical condition actively managed at the study site.

Inclusion Criteria for Family:

• Age 18 or older
• Identified as family by the patient
• Has a minimum of twice weekly total of 4 hour face-to face contact with the patient
• Is willing and available to participate in the study;
• Has access to internet.

Exclusion Criteria for Patient:

• Inability to understand screening and assessment questions
• Montreal Cognitive Assessment Scores <18
• Known diagnosis of a severe chronic mental illness such as schizophrenia
• Meeting the criteria for bipolar disorder or schizophrenia in PRIME-MD
• Deemed to be a danger to self or others that may require treatment outside a primary care setting.

Exclusion Criteria for Family:

• Institutionalized at the time of study.

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Single Blind

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60 participants in 2 patient groups

Intervention group

Experimental group

Description:

FACE-PC comprises 3 weekly and 2 bi-weekly sessions (total 5 sessions), delivered by a bachelors' prepared nurse care manager (CM) over 8 weeks. Over the five sessions, the nurse care manager will (1) review the patient medical history and set health goals for depression and chronic condition with the dyad, (2) review all medication, the level of adherence, challenges and facilitating factors of adherence, (3) deliver brief behavioral activation therapy.

Treatment:

Behavioral: FACE-PC

Enhanced usual care group

No Intervention group

Description:

Participants in this group will receive a typical primary care enhanced with reporting of their depression status and their goal for medical condition to their PCP for 8 weeks. Upon enrolment, a research nurse will review the patient medical history and identify goals for depression and a chronic condition with the dyad.