Patient Outcomes Reporting for Timely Assessments of Life With Depression: PORTAL-Depression
- Conditions
- Depressive Disorder, MajorDepression
- Interventions
- Other: CAT-DI monitoring via MyChartDiagnostic Test: CAD-MDD/CAT-DI screening via MyChartDiagnostic Test: CAD-MDD/CAT-DI screening during clinic visitOther: PHQ-9 monitoring during clinic visits
- Registration Number
- NCT03832283
- Lead Sponsor
- University of Chicago
- Brief Summary
Currently, very little research exists on whether patient portals could be used to integrate patient-reported outcome (PRO) measurement into the electronic health record (EHR) and clinical practice, even though 87% of ambulatory care practices have EHRs and 88% of U.S. adults have access to the internet. To date, no randomized controlled trial has examined whether patient portals can be used to collect PRO measures. The goal of this study is to implement the integration of a computerized adaptive test (CAT) for patient-reported outcome (PRO) measurement of depression symptoms into an electronic health record (EHR) and evaluate the effectiveness of collecting CAT PROs via an EHR patient portal in two randomized controlled trials. This study will advance the science of implementation of patient-centered outcomes research into clinical practice, as well as the evidence for high quality, accessible care.
- Detailed Description
The overall goal of this proposal is to implement the integration of the Computerized Adaptive Test for Mental Health (CAT-MH) into an EHR for a healthcare system and evaluate the effectiveness of collecting CAT-MH PROs via an EHR-tethered patient portal (MyChart) vs. usual care in two randomized controlled trials. The first aim of this study will consist of a randomized controlled trial comparing screening rates among adult primary care patients with an active patient portal account (MyChart) and due for depression screening who receive usual care (CAT-MH screenings during routine clinic visits) vs. MyChart population-based CAT-MH screenings. The second aim of this study involves a randomized controlled trial comparing depression remission rates among patients with active moderate-to-severe MDD who receive usual care vs. MyChart CAT-MH measurement-based care. In addition, we will examine the resources needed to integrate the CAT-MH into the EHR and design the health IT strategy for collecting PROs via the patient portal.
Recruitment & Eligibility
- Status
- COMPLETED
- Sex
- All
- Target Recruitment
- 4161
- 18 years or older
- considered an active clinic patient at the start date of the intervention
- have an active MyChart account that is not managed by a proxy
- receive care from a participating PCP
- due for depression screening (screening arms) or active depression (monitoring arms)
- under 18 years of age
- bipolar disorder
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description Population MyChart Depression Monitoring CAT-DI monitoring via MyChart Patients who have depression and are randomized to this intervention arm will continue to receive usual care depression monitoring when they come for clinic visits. In addition, they will receive email invitations at preset intervals to complete the CAT-DI monitoring via MyChart. Invitations will be sent until major depressive disorder (MDD) remission is achieved, or the 1-year follow-up period ends, whichever comes first. Population MyChart Depression Screening CAD-MDD/CAT-DI screening via MyChart Patients randomized to this intervention arm will continue to receive usual care annual depression screening when they come in for a clinic visit and are due for screening. In addition, they will receive email invitations to complete the CAD-MDD/CAT-DI screening via MyChart. Email invitations will be sent at preset intervals until depression screening is completed, or the end of the 1-year follow-up period, whichever comes first. Usual Care Depression Screening CAD-MDD/CAT-DI screening during clinic visit Patients randomized to this intervention arm will receive usual care annual depression screening when they come in for a clinic visit and are due for screening. When the patient comes in for a visit, a best practice alert in the EHR will indicate that the patient requires depression screening. The CAD-MDD/CAT-DI screening during clinic visit will occur in a patient room, prior to their appointment with a primary care provider. Population MyChart Depression Screening CAD-MDD/CAT-DI screening during clinic visit Patients randomized to this intervention arm will continue to receive usual care annual depression screening when they come in for a clinic visit and are due for screening. In addition, they will receive email invitations to complete the CAD-MDD/CAT-DI screening via MyChart. Email invitations will be sent at preset intervals until depression screening is completed, or the end of the 1-year follow-up period, whichever comes first. Usual Care Depression Monitoring PHQ-9 monitoring during clinic visits Patients who have depression and are randomized to this intervention arm will receive usual care PHQ-9 monitoring during clinic visits. When the patient comes in for a visit, a best practice alert in the EHR will indicate that the patient requires depression assessment. Population MyChart Depression Monitoring PHQ-9 monitoring during clinic visits Patients who have depression and are randomized to this intervention arm will continue to receive usual care depression monitoring when they come for clinic visits. In addition, they will receive email invitations at preset intervals to complete the CAT-DI monitoring via MyChart. Invitations will be sent until major depressive disorder (MDD) remission is achieved, or the 1-year follow-up period ends, whichever comes first.
- Primary Outcome Measures
Name Time Method Time to MDD remission 12 months Percentage of Patients screened for depression using the BPA by study arm 12 months Percentage of patients who have MDD remission 12 months
- Secondary Outcome Measures
Name Time Method Percentage of opened MyChart depression symptom measurement messages 12 months Percentage of patients who start CAT-DI assessments 12 months Depression severity scores (CAT-DI) 12 months Number of MyChart messages sent to PCPs by patients (or to patients by PCPs) following completion of the CAT-DI 12 months Percentage of logins to MyChart in response to the email invitations 12 months Percentage of patients who complete the CAT-MH assessment 12 months Percentage of positive screens 12 months Number of appointments scheduled and completed (primary care and psychiatry/psychology) 12 months Number of telephone encounters in the week following the positive depression screen 12 months Percentage of opened MyChart depression screening messages 12 months Number of MyChart messages sent to PCPs by patients (or to patients by PCPs) following depression screening 12 months Percentage of patients who start the CAT-MH assessment 12 months Number of emergency department visits or hospitalizations due to MDD 12 months Percentage of logins to MyChart in response to MyChart emails 12 months
Trial Locations
- Locations (1)
University of Chicago
🇺🇸Chicago, Illinois, United States