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Trial registered on ANZCTR
Registration number
ACTRN12610001037099
Ethics application status
Approved
Date submitted
7/11/2010
Date registered
24/11/2010
Date last updated
24/11/2010
Type of registration
Retrospectively registered
Titles & IDs
Public title
Specialist mental health consultation for depression in Australian aged care residents with dementia.
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Scientific title
In aged care residents with dementia, is specialist mental health consultation more effective than care as usual in the management of major depression?
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Secondary ID [1]
253039
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Nil
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Universal Trial Number (UTN)
U1111-1117-7992
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Trial acronym
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Depression
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Condition category
Condition code
Mental Health
258742
258742
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0
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Depression
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
In the intervention condition, a psychiatrist and clinical psychologist provided individually tailored medical and psychosocial recommendations to facility care staff and General Practitioners. The intervention was thus a form of consultation and training designed to improve care staff and GP management of depression. The frequency with which the psychiatrist and psychologist had contact with those providing direct care varied on a case by case basis, throughout the course of the study. The duration of the intervention was 15 weeks.
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Intervention code [1]
257565
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Other interventions
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Comparator / control treatment
The control treatment was standard care, which typically involved GP management of depression (including the use of various antidepressants) and involvement in an activities program at the facility. Activity programs offered at each facility varied markedly, as did the level of involvement of individual participants. Standard care paralelled the intervention for approximately 15 weeks.
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Control group
Active
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Outcomes
Primary outcome [1]
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Cornell Scale for Depression in Dementia (CSDD)
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Assessment method [1]
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Timepoint [1]
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Approximately 15-weeks after intervention commencement
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Primary outcome [2]
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DSM-IV Depression Diagnosis were also made, facilitated by checklists of DSM-IV criteria. Note that standard diagnostic tests could not be used, because our participants all had considerable cognitive impairment. The assessing clinician reviewed all potential cases with a senior team member in order to confirm the diagnosis.
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Assessment method [2]
259604
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Timepoint [2]
259604
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Approximately 15-weeks after intervention commencement
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Secondary outcome [1]
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Rating Anxiety in Dementia (RAID) Scale
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Assessment method [1]
266244
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Timepoint [1]
266244
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Approximately 15-weeks after intervention commencement
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Secondary outcome [2]
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Behavioral and Psychological Symptoms of Dementia, as measured by the BEHAVE-AD.
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Assessment method [2]
266245
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Timepoint [2]
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Approximately 15-weeks after intervention commencement
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Eligibility
Key inclusion criteria
Permanent resident of aged care facility; </= 23 on the MMSE and a PAS Cognitive Decline Informant History of greater than or equal to 4 or their facility record referred to presence of cognitive impairment; diagnosis of DSM-IV Major Depression.
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Minimum age
60
Years
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Maximum age
No limit
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
No history of English language proficiency; the resident did not have a family member or friend who could provide information about the resident's emotional well-being.
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Study design
Purpose of the study
Educational / counselling / training
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Allocation to intervention
Randomised controlled trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
Study was a clustered randomized controlled trial where individual facilities were randomized. Allocation was not concealed.
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Facilities were randomized by coin-toss.
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Masking / blinding
Blinded (masking used)
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Who is / are masked / blinded?
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Intervention assignment
Parallel
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Other design features
Study was a clustered randomized controlled trial where individual facilities were randomized.
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Phase
Not Applicable
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Type of endpoint/s
Efficacy
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Statistical methods / analysis
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Recruitment
Recruitment status
Completed
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Date of first participant enrolment
Anticipated
1/05/2007
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Actual
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Date of last participant enrolment
Anticipated
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Actual
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Date of last data collection
Anticipated
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Actual
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Sample size
Target
44
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Accrual to date
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Final
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Recruitment in Australia
Recruitment state(s)
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Recruitment postcode(s) [1]
3412
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3192
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Recruitment postcode(s) [2]
3413
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3162
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Recruitment postcode(s) [3]
3414
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3196
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Recruitment postcode(s) [4]
3415
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3186
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Recruitment postcode(s) [5]
3416
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3191
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Recruitment postcode(s) [6]
3417
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3194
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Recruitment postcode(s) [7]
3418
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3163
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Recruitment postcode(s) [8]
3419
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3181
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Recruitment postcode(s) [9]
3420
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3168
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Recruitment postcode(s) [10]
3421
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3206
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Recruitment postcode(s) [11]
3422
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3174
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Recruitment postcode(s) [12]
3423
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3187
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Recruitment postcode(s) [13]
3424
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3150
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Funding & Sponsors
Funding source category [1]
258016
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Charities/Societies/Foundations
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Name [1]
258016
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beyondblue: the national depression initiative
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Address [1]
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PO Box 6100
Hawthorn West
VICTORIA 3122
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Country [1]
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Australia
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Primary sponsor type
University
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Name
Monash University
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Address
Monash University
Victoria 3800
Australia
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Country
Australia
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Secondary sponsor category [1]
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None
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Name [1]
257210
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Address [1]
257210
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Country [1]
257210
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
260009
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Monash University Human Research Ethics Committee
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Ethics committee address [1]
260009
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Human Ethics Office First Floor, Building 3e Monash Research Office Clayton Campus Monash University VIC 3800
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Ethics committee country [1]
260009
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Australia
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Date submitted for ethics approval [1]
260009
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Approval date [1]
260009
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12/04/2007
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Ethics approval number [1]
260009
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CF07/0146 - 2007/0032
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Summary
Brief summary
This project sought to determine whether specialist mental health consultation was more effective in treating the depressions of aged care residents with dementia than standard care. We screened 389 aged care residents for dementia and major depression. Forty-four were ultimately included in the intervention sample, selected from 20 aged care facilities located in Melbourne, Australia. Facilities were allocated to an intervention condition involving the provision of multidisciplinary specialist consultation surrounding the best-practice management of depression in dementia, or to a care as usual condition. Consultations involved individually tailored medical and psychosocial recommendations provided to care staff and General Practitioners (GPs). All residents participated in a comprehensive pre-intervention diagnostic assessment, including the administration of the Cornell Scale for Depression in Dementia (CSDD). This assessment was repeated approximately 15 weeks post-intervention by a rater blind to study condition. We found that specialist mental health consultation was significantly more effective in treating the clinical depressions of aged care residents with dementia than care as usual. At follow-up, the majority of the intervention group no longer met criteria for major depression, nor did they score above critical values on the CSDD. These results suggest that the psychosocial and medical management of depressed aged care residents can be improved by increasing access to specialist mental health consultation.
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Trial website
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
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Address
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Country
31882
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Phone
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Fax
31882
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Email
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Contact person for public queries
Name
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Professor Daniel O'Connor
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Address
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Aged Mental Health Research Unit
Kingston Centre
Warrigal Road
Cheltenham
VICTORIA 3192
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Country
15129
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Australia
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Phone
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+61 3 9265 1700
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Fax
15129
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+61 3 9265 1711
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Email
15129
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[email protected]
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Contact person for scientific queries
Name
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Professor Daniel O'Connor
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Address
6057
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Aged Mental Health Research Unit
Kingston Centre
Warrigal Road
Cheltenham
VICTORIA 3192
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Country
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Australia
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Phone
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+61 3 9265 1700
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Fax
6057
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+61 3 9265 1711
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Email
6057
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[email protected]
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No information has been provided regarding IPD availability
What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
No additional documents have been identified.
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