During pandemics older adults with chronic physical conditions are a particularly vulnerable population for unmet mental health needs. This is a consequence of a number of factors which include decreased access to their doctors because of restrictions in visits in order to decrease risk of disease transmission and because doctors are seconded to provide medical services in areas of high priority. Since Public Health authorities worry that pandemics may be a reality of the future, this study is being operationalized during the present COVID-19 pandemic in order to see what can be learned about different ways to provide mental health care under such constraints. The study offers evidence-based approaches to managing feelings of anxiety or depression that may have existed prior to the onset of a pandemic, or that have arisen during a pandemic. It uses principles of cognitive behavioural therapy in which participants are offered self-care tools to help them develop strategies for dealing with their various symptoms. These tools have already been shown by the team to be effective in other contexts in studies DIRECT-sc (Effectiveness of a supported self-care intervention for depression compared to an unsupported intervention in older adults with chronic physical illnesses) and CanDIRECT (Effectiveness of a telephone-supported depression self-care intervention for cancer survivors). The present study, PanDIRECT (Assisting Family Physicians with Gaps in Mental Health Care Generated by the COVID-19 Pandemic), aims to answer the following questions: 1. Can these tools be used in the community care of mental health problems during pandemics? 2. Are they acceptable to patients? 3. Using a randomized control trial, does lay-coaching of use of these tools improve their use and patient outcomes? 4. Do family practitioners value patient information sent to them at the end of the trial
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
SUPPORTIVE_CARE
Masking
SINGLE
Enrollment
90
self-care tools only
coaching
St Mary's Hospital Research Centre
Montreal, Canada
Consent rate
Number of consenting participants out of total number contacted over the recruitment period
Time frame: At recruitment
Data completion rate
Investigators will report on rates of missing data from baseline and follow-up questionnaires
Time frame: From recruitment launch to completion of follow-up (4 months)
Fidelity of intervention completion
Logs and checklists will be used to evaluate completion of intervention, as per protocol
Time frame: A 8 week follow-up
Severity of depression symptoms
Using the validated 9 item Patient Health Questionnaire (PHQ-9). Scores range from 0 to 27 - higher score indicates more severe depression
Time frame: At baseline
Severity of depression symptoms
Using the validated 9 item Patient Health Questionnaire (PHQ-9). Scores range from 0 to 27 - higher score indicates more severe depression
Time frame: At 8 week follow-up
Severity of anxiety symptoms
Using the validated 7 item General Anxiety Disorder (GAD-7) instrument. Scores range from 0 to 21 - higher score indicates more severe anxiety
Time frame: At baseline
Severity of anxiety symptoms
Using the validated 7 item General Anxiety Disorder (GAD-7) instrument. Scores range from 0 to 21 - higher score indicates more severe anxiety
Time frame: At 8 week follow-up
Use of health care services
Using questions developed by the team and administrative databases to assess use of hospital and mental health care services
Time frame: At baseline
Use of health care services
Using questions developed by the team and administrative databases to assess use of hospital and mental health care services
Time frame: At 8 week follow-up
Use of the self-care materials
Using adherence questions developed by the team, not scored
Time frame: At 8 week follow-up
This platform is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional.