Treatment of Depressed Chronic Obstructive Pulmonary Disease Patients

Weill Cornell Medicine (WCM)

Status: Completed

Conditions: Major Depression; Pulmonary Disease, Chronic Obstructive

Treatments: Behavioral: Enhanced Care; Behavioral: Treatment Adherence Intervention

Study type: Interventional

Funder types: Other; NIH

Identifiers

NCT00151372

R01HL071992-05 (U.S. NIH Grant/Contract)

0201005319

Details and patient eligibility

About

Approximately 20% of patients with chronic obstructive pulmonary disease (COPD) have major depression, a condition that contributes to suffering but also to poor treatment adherence leading to increased disability and morbidity. This study investigates the effectiveness of a care management intervention aimed at facilitating adherence to a treatment algorithm based on the Agency for Health Care Policy and Research (AHCPR) guidelines. The investigators hypothesize that this intervention, in comparison to usual care, will increase the prescription of adequate antidepressant treatment by physicians, enhance treatment adherence by patients, and reduce depressive symptoms, suicide ideation, and disability at a 28-week follow-up period.

Enrollment: 141 patients

Sex: All

Ages: 50 to 95 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Chronic obstructive pulmonary disease by American Thoracic Society criteria
• Major depression by DSM-IV criteria
• 17-item Hamilton score >14
• English speaking

Exclusion criteria

• Inability to give informed consent
• MiniMental score <24
• Aphasia
• Nursing home placement after discharge

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: None (Open label)

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141 participants in 2 patient groups

Treatment Adherence Intervention

Experimental group

Description:

In the Treatment Adherence Intervention group, a study therapist regularly meets with subjects in order to identify obstacles to depression and chronic obstructive pulmonary disease treatment adherence and to help the participant overcome those obstacles.

Treatment:

Behavioral: Treatment Adherence Intervention

Enhanced Care

Active Comparator group

Description:

In the Enhanced Care group, physicians providing aftercare will be informed in writing of the patients' diagnosis but will receive no clinical instructions by the research team.

Treatment:

Behavioral: Enhanced Care