Last reviewed · How we verify

NCT02990000

Enhancing Mental Health Care by Scientifically Matching Patients to Providers' Strengths

Completed NA Results posted Last updated 30 July 2020
What this trial tests

NA trial testing Scientific Match in Mental Illness in 288 participants. Completed in 15 March 2020.

Timeline
6 November 2017
Primary endpoint
23 September 2019
15 March 2020

Quick facts

Lead sponsorUniversity of Massachusetts, Amherst
PhaseNA
StatusCompleted
Study typeINTERVENTIONAL
Allocationrandomized
Designparallel
Maskingdouble
Primary purposehealth services research
Enrollment288
Start date6 November 2017
Primary completion23 September 2019
Estimated completion15 March 2020
Sites1 location across United States

Drugs / interventions tested

Conditions studied

Sponsor

University of Massachusetts, Amherst

Who can join

Adults 18 to 70, any sex, with Mental Illness. Patients with the condition only — healthy volunteers not accepted.

Results — posted to ClinicalTrials.gov

Per-arm endpoint measurements with 95% confidence intervals where reported. Source: trial results section.

Average Z-Scores for the Treatment Outcome Package-Clinical Scales (TOP-CS; Kraus, Seligman, & Jordan, 2005) Primary · Baseline and biweekly across 16 weeks

The TOP-Clinical Scales consist of 58 items assessing 12 symptom and functional domains (risk-adjusted for case mix variables assessed via 37 items on the companion TOP-Case Mix form, such as divorce, job loss, comorbidity): work functioning, sexual functioning, social conflict, depression, panic/somatic anxiety, psychosis, suicidal ideation, violence, mania, sleep, substance abuse, and quality of life. Global symptom severity was assessed by averaging the z-scores (i.e., standard deviation units relative to the general population mean) across the 12 clinical scales. Higher scores indicate gre

GroupValue95% CI
Pragmatic Match0.57± 0.80
Scientific Match0.56± 0.82
Symptom Checklist-10 (SCL-10; Rosen, Drescher, Moos, & Gusman, 1999) Total Score Secondary · Baseline and biweekly across 16 weeks

Global psychological distress was assessed with the Symptom Checklist-10 (SCL-10; Rosen, Drescher, Moos, \& Gusman, 1999), a 10-item, well validated and widely used self-report inventory that assesses psychological well-being. Total scores can range from 0 to 40, with higher scores indicating greater distress. Given that we examined change over the entire treatment period for this outcome (in a longitudinal hierarchical linear model), we provide the average mean and standard deviation for the SCL-10 total score across all measurement occasions.

GroupValue95% CI
Pragmatic Match12.52± 8.01
Scientific Match12.06± 7.70
Working Alliance Inventory-Short Form, Patient Version (WAI-SF-P; Tracey, & Kokotovic, 1989) Total Score Secondary · Biweekly across 16 weeks

The WAI is the most widely used alliance measure, assessing patient-therapist agreement on the goals and tasks of treatment, and the quality of their relational bond. This 12-item short form assesses these dimensions from the patient's perspective, with higher scores indicating a more positive relationship (theoretical range = 12 to 84). Given that we examined change over the entire treatment period for this outcome (in a longitudinal hierarchical linear model), we provide the average mean and standard deviation for the WAI total score across all measurement occasions.

GroupValue95% CI
Pragmatic Match66.75± 13.35
Scientific Match68.44± 12.00
Outcome Expectation (OE) Subscale of the Credibility/Expectancy Scale (CEQ; Devilly, & Borkovec, 2000) Secondary · Biweekly across 16 weeks

The OE subscale of the CEQ is the most widely used and psychometrically sound measure of patients' expectations for the personal efficacy of treatment. The three OE items range from 1-9 or 0-100% (in 10 percentage point increments), with higher ratings indicating greater expectation for improvement. Given that the OE CEQ items are assessed on different scales, we re-scaled the items to the same metric before creating a total score (theoretical range = 3 to 27). Given that we examined change over the entire treatment period for this outcome (in a longitudinal hierarchical linear model), we prov

GroupValue95% CI
Pragmatic Match18.12± 5.45
Scientific Match19.15± 5.30
Domain-Specific Impairment on the Most Elevated Domain of the Treatment Outcome Package-Clinical Scales (TOP-CS) Secondary · Baseline and biweekly across 16 weeks

The TOP-CS consists of 58 items assessing 12 symptom and functional domains (risk-adjusted for case mix variables assessed via 37 items on the companion TOP-Case Mix form, such as divorce, job loss, comorbidity): work functioning, sexual functioning, social conflict, depression, panic/somatic anxiety, psychosis, suicidal ideation, violence, mania, sleep, substance abuse, and quality of life. Domain-specific impairment reflects each patient's scores on their most elevated problem domain (i.e., the domain most elevated at baseline). These scores were standardized z-scores (i.e., standard deviati

GroupValue95% CI
Pragmatic Match0.27± .24
Scientific Match0.28± 0.23
Early Treatment Discontinuation (i.e., Attending 2 or Fewer Treatment Sessions) Secondary · Early treatment discontinuation/continuation at session 2

Early treatment discontinuation was operationalized as a patient discontinuing treatment after 2 or fewer sessions, whereas early continuation was operationalized as attending 3 or more treatment sessions. For analyses, early treatment discontinuation was coded 1 and early continuation was coded 0.

GroupValue95% CI
Pragmatic Match22
Scientific Match22
Overall Provider Quality Subscale of the Treatment Outcome Package (TOP) Satisfaction Scale Secondary · Assessed after 16 weeks of treatment or at the point of naturalistic treatment termination, whichever comes sooner

The Overall Provider Quality subscale of the TOP Satisfaction Scale assesses the extent to which patients are satisfied with their mental health care provider. This subscale reflects the average of 4 items, with higher scores indicating greater satisfaction (theoretical range = 1 to 6).

GroupValue95% CI
Pragmatic Match5.01± 1.35
Scientific Match5.17± 1.11

Sponsor's own description

Research has shown that mental health care (MHC) providers differ significantly in their ability to help patients. In addition, providers demonstrate different patterns of effectiveness across symptom and functioning domains. For example, some providers are reliably effective in treating numerous patients and problem domains, others are reliably effective in some domains (e.g., depression, substance abuse) yet appear to struggle in others (e.g., anxiety, social functioning), and some are reliably ineffective, or even harmful, across patients and domains. Knowledge of these provider differences is based largely on patient-reported outcomes collected in routine MHC settings. Unfortunately, provider performance information is not systematically used to refer or assign a particular patient to a scientifically based best-matched provider. MHC systems continue to rely on random or purely pragmatic case assignment and referral, which significantly "waters down" the odds of a patient being assigned/referred to a high performing provider in the patient's area(s) of need, and increases the risk of being assigned/referred to a provider who may have a track record of ineffectiveness. This research aims to solve the existing non-patient-centered provider-matching problem. Specifically, the investigators aim to demonstrate the comparative effectiveness of a scientifically-based patient-provider match system compared to status quo pragmatic case assignment. The investigators expect in the scientific match group significantly better treatment outcomes (e.g., symptoms, quality of life) and higher patient satisfaction with treatment. The investigators also expect to demonstrate feasibility of implementing a scientific match process in a community MHC system and broad dissemination of the easily replicated scientific match technology in diverse health care settings. The importance of this work for patients cannot be understated. Far too many patients struggle to find the right provider, which unnecessarily prolongs suffering and promotes health care system inefficiency. A scientific match system based on routine outcome data uses patient-generated information to direct this patient to this provider in this setting. In addition, when based on multidimensional assessment, it allows a wide variety of patient-centered outcomes to be represented (e.g., symptom domains, functioning domains, quality of life).

Publications & conference data

2 peer-reviewed publications reference this trial (live from Europe PMC):

  1. Effect of Matching Therapists to Patients vs Assignment as Usual on Adult Psychotherapy Outcomes: A Randomized Clinical Trial.
    Constantino MJ, Boswell JF, Coyne AE, Swales TP, et al · · 2021 · cited 32× · PMID 34106240 · DOI 10.1001/jamapsychiatry.2021.1221
  2. Therapist-Level Moderators of Patient-Therapist Match Effectiveness in Community Psychotherapy.
    Coyne AE, Constantino MJ, Boswell JF, Gaines AN, et al · · 2024 · cited 1× · PMID 38565810 · DOI 10.1007/s10488-024-01360-8

Verify or expand the search:

Other recruiting trials for Mental Illness

Currently open trials in the same condition.

Other University of Massachusetts, Amherst trials

Trials by the same sponsor.

Verify against primary sources

Data sources for this page

Drug Landscape aggregates and links these public records for informational use only. Always verify against the primary source before clinical or regulatory decisions. Canonical URL: https://druglandscape.com/trial/NCT02990000.

Primary sources · FDA · ClinicalTrials.gov · EMA · SEC EDGAR · ChEMBL · Wikidata · full sourcing