Outreach to Reduce Depression Disparities

Kaiser Permanente

Status: Invitation-only

Conditions: Depression

Treatments: Behavioral: Outreach messaging

Study type: Interventional

Funder types: Other

Identifiers

NCT05580406

12874

Details and patient eligibility

About

Previous research by Mental Health Research Network (MHRN) investigators and others demonstrates that online messaging and other telehealth technologies can effectively and efficiently address premature discontinuation of depression treatment. These interventions, however, have focused on adherence after treatment initiation and have been tested primarily in non-Hispanic white populations. Less is known about the acceptability and effectiveness of different communication modalities (online messaging, mailed letters, telephone) among racial and ethnic minority populations. Implementation of electronic-Health (eHealth) technologies must take care not to exacerbate health disparities.

This clinical trial involves a pilot trial to evaluate a population-based outreach program to improve rates of depression treatment initiation among traditionally underserved racial and ethnic groups. This pilot work intends to inform a subsequent full-scale pragmatic trial to examine impact on health disparities.

Enrollment: 400 estimated patients

Sex: All

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• New diagnosis of major depressive disorder or dysthymic disorder at a primary care visit ("new" defined as no depression diagnosis, psychotherapy visit or filled antidepressant prescription in the prior year)
• Continuously enrolled in the participating health system for 365 days prior to the eligible diagnosis (to assure capture of prior diagnoses or treatments)
• Patients Health Questionnaire-9 (PHQ-9) depression score of 10 or more within 14 days before to 7 days after the eligible diagnosis
• No filled prescription for any antidepressant medication OR psychotherapy visit attended within 30 days of the eligible diagnosis*
• No recorded PHQ-9 depression score less than 5 since the eligible diagnosis
• At least 18 years of age or older

Exclusion criteria

• Diagnosis of schizophrenia or bipolar disorder in the prior 2 years
• Not registered to use Electronic Health Record (EHR) patient portal
• Previously requested to not be contacted for research

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: None (Open label)

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400 participants in 2 patient groups

Usual Care

No Intervention group

Description:

Participants assigned to usual care will not receive outreach messages (online or via telephone) by study staff.

Outreach Messaging

Experimental group

Description:

Participants in the outreach messaging arm will receive messages via online secure message system (embedded within the health care record) and/or telephone.

Treatment:

Behavioral: Outreach messaging