Ignite Creation Date:
2024-05-05 @ 12:10 PM
Last Modification Date:
2024-10-26 @ 9:21 AM
Study NCT ID:
NCT00260013
Status:
COMPLETED
Last Update Posted:
2010-03-23
First Post:
2005-11-29
Brief Title:
Transition Into Primary-care Psychiatry TIPP
Sponsor:
Lawson Health Research Institute
Organization:
Lawson Health Research Institute
Study Overview
Official Title:
Transition Into Primary-care Psychiatry TIPP A Mental Health Demonstration Project
Status:
COMPLETED
Status Verified Date:
2010-03
Last Known Status:
None
Delayed Posting:
No
If Stopped, Why?:
Not Stopped
Has Expanded Access:
False
If Expanded Access, NCT#:
N/A
Has Expanded Access, NCT# Status:
N/A
Acronym:
None
Brief Summary:
The objective of the Transition into Primary-care Psychiatry TIPP project is to determine how feasible it is to conduct a study to evaluate a new primary-care focused program of mental health care delivery for people with chronic mental illness This will be done by comparing a primary-care based collaborative interdisciplinary model to care-as-usual on health related quality of life client symptomatology clients perceived need of care participant satisfaction and cost-effectiveness
Detailed Description:
The TIPP service will consist at both the London and Thunder bay sites of i a mental health care nurse BScN with at least several years experience as an outpatient mental health service clinician and ii a psychiatrist with a license to practice medicine in the Province of Ontario and sensitivity to the issues of family physicians providing mental health services in the community
The TIPP intervention will involve a service delivery that is a modification of the Consultation Liaison in Primary-care Psychiatry CLIPP program
Four elements will act in synthesis and enable collaboration between the primary care and TIPP teams
i Co-location of mental health services staff will involve the psychiatric nurse and psychiatrist visiting the family physicians office at 1 and 3-month intervals respectively During these visits they will review and document the clients progress This empowers the family physician as clinical manager Treatment plans will be developed for family physicians that can be easily implemented The family physician will monitor the clients status between the psychiatric nurse and psychiatrists visits At times of greater need andor impending crisis increase in contact to every 14 days with weekly or more from the family physician and contacts with all providers adjusted to accommodate client needs By developing linkages with area mental health services the psychiatric nurse will assist the family physician in co-coordinating access while minimizing redundant use to these services
ii The TIPP nurse will select prepare and facilitate appropriate clients from the outpatient department for transfer to the family physician The initial transfer process includes a face-to-face meeting with the client TIPP nurse and family physician in family physicians office Warning signs and symptoms of an impending relapse will allow for an opportunity for intervention to prevent or lessen the severity of a relapse For each client a relapse signature strategy will be developed by the TIPP nurse to assist the family physician in detecting clients at high risk of mental illness relapse Having obtained the clients permission significant caregivers will be routinely involved in the development and implementation of a clinical management plan Standardized CLIPP based contact sheetsdata sheets will promote efficient and effective communication between clinical care providers
iii Client monitoring will be maintained by administrative staff support procedures targeted at ensuring a high level of retention and effective client follow up The family physician will complete a Clinical Global Impression Scale CGIS severity and change scores every 3 months in the first year then at each visit for the remainder of the project The CGIS will not add time to the clinical time with the clients An administrative member of the project receiving these scales will alert the appropriate clinical providers for clients whose condition is not improving as judged by the family physician
iv Telephone back up for the family physicians whose clients are involved in the project will be provided by a project psychiatrist andor psychiatric nurse
The outcomes of the TIPP intervention clients will be compared to those who receive post outpatient service transfer care-as-usual from their family physician The clients in this group will obtain any and all services normally available inside or outside their primary care service including re-referral to specialty mental health care No additional services will be provided for the care-as-usual group but no usual services will be limited or withheld Design features to ensure the interests of the control group are considered include outcomes assessment for both groups at 6 and 12 months as well as at the projects end point Should significant clinical concerns be noted by the rater during the assessment a systematic process will allow for the family physician to be notified so as to minimize the risk of compromised care
The TIPP intervention will involve a service delivery that is a modification of the Consultation Liaison in Primary-care Psychiatry CLIPP program
Four elements will act in synthesis and enable collaboration between the primary care and TIPP teams
i Co-location of mental health services staff will involve the psychiatric nurse and psychiatrist visiting the family physicians office at 1 and 3-month intervals respectively During these visits they will review and document the clients progress This empowers the family physician as clinical manager Treatment plans will be developed for family physicians that can be easily implemented The family physician will monitor the clients status between the psychiatric nurse and psychiatrists visits At times of greater need andor impending crisis increase in contact to every 14 days with weekly or more from the family physician and contacts with all providers adjusted to accommodate client needs By developing linkages with area mental health services the psychiatric nurse will assist the family physician in co-coordinating access while minimizing redundant use to these services
ii The TIPP nurse will select prepare and facilitate appropriate clients from the outpatient department for transfer to the family physician The initial transfer process includes a face-to-face meeting with the client TIPP nurse and family physician in family physicians office Warning signs and symptoms of an impending relapse will allow for an opportunity for intervention to prevent or lessen the severity of a relapse For each client a relapse signature strategy will be developed by the TIPP nurse to assist the family physician in detecting clients at high risk of mental illness relapse Having obtained the clients permission significant caregivers will be routinely involved in the development and implementation of a clinical management plan Standardized CLIPP based contact sheetsdata sheets will promote efficient and effective communication between clinical care providers
iii Client monitoring will be maintained by administrative staff support procedures targeted at ensuring a high level of retention and effective client follow up The family physician will complete a Clinical Global Impression Scale CGIS severity and change scores every 3 months in the first year then at each visit for the remainder of the project The CGIS will not add time to the clinical time with the clients An administrative member of the project receiving these scales will alert the appropriate clinical providers for clients whose condition is not improving as judged by the family physician
iv Telephone back up for the family physicians whose clients are involved in the project will be provided by a project psychiatrist andor psychiatric nurse
The outcomes of the TIPP intervention clients will be compared to those who receive post outpatient service transfer care-as-usual from their family physician The clients in this group will obtain any and all services normally available inside or outside their primary care service including re-referral to specialty mental health care No additional services will be provided for the care-as-usual group but no usual services will be limited or withheld Design features to ensure the interests of the control group are considered include outcomes assessment for both groups at 6 and 12 months as well as at the projects end point Should significant clinical concerns be noted by the rater during the assessment a systematic process will allow for the family physician to be notified so as to minimize the risk of compromised care
Study Oversight
Has Oversight DMC:
None
Is a FDA Regulated Drug?:
None
Is a FDA Regulated Device?:
None
Is an Unapproved Device?:
None
Is a PPSD?:
None
Is a US Export?:
None
Is an FDA AA801 Violation?:
None
Secondary IDs
| Secondary ID | Type | Domain | Link |
|---|---|---|---|
| 10349E | OTHER | University of Western Ontario Research Ethics Board | None |
| G03-05687 | OTHER_GRANT | None | None |