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Telephone-Based Support Programs for People With Epilepsy

Not Applicable
Recruiting
Conditions
Epilepsy
Interventions
Behavioral: UPLIFT (Using Practice and Learning to Increase Favorable Thoughts)
Behavioral: BOOST (Bringing Out Our Strength Together)
Registration Number
NCT05082181
Lead Sponsor
NYU Langone Health
Brief Summary

This is a two-arm randomized controlled trial to compare telephone-based depression self-management (UPLIFT) to telephone-based support groups (BOOST). A sample of 120 English- and Spanish-speaking people with epilepsy (PWE) with elevated depressive symptoms will be enrolled. Both interventions are 8-week programs delivered in one-hour weekly sessions to groups of about 6 participants. Changes in depressive symptoms, quality of life and seizures will be assessed over 12 months. The trial will also examine mediators and moderators of treatment effects.

Detailed Description

The objectives of the trial are:

1. To test effects of UPLIFT versus BOOST on changes in depressive symptoms (primary outcome) in PWE over 12 months.

2. To test effects of UPLIFT versus BOOST on changes in quality of life and seizures (secondary outcomes) in PWE over 12 months.

3. To test whether intervention effects are mediated by increases in mindfulness and decreases in rumination.

4. To test whether intervention effects are moderated by participant characteristics and facilitator characteristics.

Recruitment & Eligibility

Status
RECRUITING
Sex
All
Target Recruitment
120
Inclusion Criteria
  • adult (≥18 years of age);
  • diagnosed with epilepsy for at least one year;
  • fluent in English or Spanish;
  • elevated depressive symptoms (PHQ-9 score ≥10);
  • willing to participate in audiotaped group telephone sessions
Exclusion Criteria
  • severe depressive symptoms (PHQ-9 ≥20);
  • active suicidal ideation (PHQ-9 item #9 ≥1 or otherwise reported during screening);
  • active psychotic disorder (psychiatric diagnosis or antipsychotic medications in the EHR);
  • significant cognitive impairment (indicated in EHR or evident during screening)

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Arm 1: UPLIFT (Using Practice and Learning to Increase Favorable Thoughts)UPLIFT (Using Practice and Learning to Increase Favorable Thoughts)UPLIFT is a telephone-based depression self-management program for people with epilepsy.
Arm 2: BOOST (Bringing Out Our Strength Together)BOOST (Bringing Out Our Strength Together)BOOST is a telephone-based support program for people with epilepsy.
Primary Outcome Measures
NameTimeMethod
Presence of clinically significant depressive symptoms12 month visit

The primary outcome is a dichotomous measure of depressive symptoms based on a Patient Health Questionnaire (PHQ-9) score of \<5 versus ≥5. The PHQ-9 assesses depressive symptoms in the past two weeks. Total scores range from 0-27 with recommended cutoffs for mild (5-9), moderate (10-14), moderately severe (15-19) and severe (≥20) depressive symptoms. A PHQ-9 score of \<5 indicates absence of clinically significant depressive symptoms.

Secondary Outcome Measures
NameTimeMethod
Change in seizure frequencyBaseline Visit, 3 month visit, 6 month visit, 12 month visit

This will be assessed by self-reported 30-day seizure counts.

Change in depressive symptom severityBaseline Visit, 3 month visit, 6 month visit, 12 month visit

Continuous PHQ-9 scores will be used to evaluate the magnitude of change in depressive symptoms. The PHQ-9 consists of nine questions that ask respondents how often they've "been bothered by any of the following problems" in the past two weeks. The questions address sleep, energy, appetite, and other possible symptoms of depression. Scores are calculated based on how frequently a person experiences these feelings. Score of 1-4 is considered minimal depression; score of 5-9 is considered mild depression; score of 10-14 is considered moderate depression; score of 15-19 is considered moderately severe depression; score of 20-27 is considered severe depression.

Change in seizure severityBaseline Visit, 3 month visit, 6 month visit, 12 month visit

This will be assessed by a 12-item version of the Liverpool Seizure Severity Scale. The possible scoring ranges are between 7 and 32 for the percept scale and between 10 and 48 for the ictal/postictal scale. The higher the score the more severe the seizures.

Change in general health-related quality of lifeBaseline Visit, 3 month visit, 6 month visit, 12 month visit

This will be assessed by the Patient-Reported Outcomes Measurement Information System (PROMIS-10) questionnaire, a 10-item measure of global health (physical, mental and social functioning) developed by NIH as an indicator for Healthy People 2020. The PROMIS Global-10 is a 10-item patient-reported questionnaire in which the response options are presented as 5-point (as well as a single 11-point) rating scales. The results of the questions are used to calculate two summary scores: a Global Physical Health Score and a Global Mental Health score. These scores are then standardized to the general population, using the "T-Score". The average "T-Score" for the United States population is 50 points, with a standard deviation of 10 points. Higher scores indicate a healthier patient.

Change in disease-specific quality of lifeBaseline Visit, 3 month visit, 6 month visit, 12 month visit

This will be assessed by the Quality of Life in Epilepsy-10 (QOLIE-10) questionnaire, a 10-item measure of epilepsy-specific aspects of qualify of life. The QOLIE-10-P is a brief survey of health-related quality of life for adults with epilepsy. There are 10 questions about health and daily activities, one question about how much distress you feel about problems and worries related to epilepsy, and a review of what bothers you most.

Trial Locations

Locations (1)

NYU Langone Health

🇺🇸

New York, New York, United States

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