What is the mechanism of action of this treatment?

Common treatments for depression include pharmacological approaches like SSRIs, SNRIs, and tricyclic antidepressants, which work by adjusting neurotransmitter levels in the brain to improve mood. Non-pharmacological treatments such as Cognitive Behavioral Therapy (CBT) and Behavioral Activation (BA) focus on changing negative thought patterns and increasing engagement in positive activities. Personalized interventions, like the DAPPER study involving nurse visits, address both pain and mood, offering a holistic approach that can be particularly effective for patients with co-occurring physical and mental health issues. Understanding these mechanisms is crucial for tailoring treatments to individual needs, thereby enhancing the overall effectiveness of depression management.

What side effects are associated with this type of intervention?

Common treatments for depression include antidepressants, cognitive-behavioral therapy (CBT), and interpersonal psychotherapy (IPT). Antidepressants, such as SSRIs and SNRIs, can cause side effects like nausea, weight gain, sexual dysfunction, and insomnia. CBT and IPT, which are psychotherapeutic approaches, generally have fewer physical side effects but may cause emotional discomfort as patients confront challenging thoughts and feelings. Personalized nurse visits, as in the DAPPER intervention, aim to manage pain and mood, potentially reducing the need for higher doses of medication and their associated side effects.

What prior FDA approvals exist?

FDA-approved treatments for depression include a variety of antidepressants such as selective serotonin reuptake inhibitors (SSRIs) like fluoxetine and sertraline, serotonin-norepinephrine reuptake inhibitors (SNRIs) like duloxetine and venlafaxine, and tricyclic antidepressants (TCAs) like amitriptyline. These medications are often used in combination with other therapeutic approaches, such as cognitive-behavioral therapy (CBT), to manage both mood and associated symptoms like pain. The DAPPER intervention, which includes personalized nurse visits, aligns with a comprehensive treatment strategy that may incorporate these FDA-approved medications to address both depressive symptoms and pain.

What other types of research exist?

Promising alternatives to the DAPPER intervention for managing pain and mood in depression patients include: 1) Technology-enhanced Cognitive Behavioral Therapy (CBT) such as web-based or smartphone applications, which have shown efficacy in improving treatment outcomes. 2) Mindfulness-Based Cognitive Therapy (MBCT), which has demonstrated effectiveness in reducing pain and depressive symptoms. 3) Integrative therapies like yoga and guided imagery, which have been beneficial in managing pain and improving mood. 4) Behavioral family counseling, which leverages family support to enhance treatment adherence and outcomes.

← Back to Search

Behavioral Intervention

DAPPER Intervention for Depression and Pain (DAPPER Trial)

N/A

Waitlist Available

Led By Janiece L Taylor, PhD

Research Sponsored by Johns Hopkins University

Eligibility Criteria Checklist

Specific guidelines that determine who can or cannot participate in a clinical trial

Must have

One ADL or IADL limitation

Self-report pain >3 out of a 0 -10 scale that has lasted longer than 3 months and keeps subjects from doing at least one activity that subjects would like to do

Must not have

Hospitalized > 3 times in the last year

Timeline

Screening 3 weeks

Treatment Varies

Follow Up baseline, 12 weeks and 24 weeks

Awards & highlights

No Placebo-Only Group

Summary

This trial tests a program called DAPPER, where nurses visit African American women aged 50+ at home to help them manage pain and depression. The nurses provide personalized support to improve the participants' physical and emotional well-being.

Who is the study for?

This trial is for African American women over 50 who live at home, have some difficulty with daily activities due to frailty, experience persistent pain that interferes with their activities, and show signs of depression. They should not be in physical therapy or have severe mental impairment.

What is being tested?

The DAPPER intervention involves eight home visits by a nurse to assist participants with managing pain and improving mood. It's designed specifically for older African American women struggling with mobility due to pain and depression.

What are the potential side effects?

Since the DAPPER intervention is non-pharmaceutical, focusing on nursing support rather than medication, specific side effects are not anticipated as commonly seen in drug trials.

Eligibility Criteria

Inclusion Criteria

You may be eligible if you check “Yes” for the criteria below

Select...

I need help with at least one daily activity.

Select...

I have pain over 3/10 that stops me from doing activities and it's lasted more than 3 months.

Exclusion Criteria

You may be eligible for the trial if you check “No” for criteria below:

Select...

I have been hospitalized more than three times in the past year.

Timeline

Screening ~ 3 weeks3 visits

Treatment ~ Varies

Follow Up ~ baseline, 12 weeks and 24 weeks

Screening ~ 3 weeks

Treatment ~ Varies

Follow Up ~baseline, 12 weeks and 24 weeks

This trial's timeline: 3 weeks for screening, Varies for treatment, and baseline, 12 weeks and 24 weeks for reporting.

Treatment Details

Study Objectives

Study objectives can provide a clearer picture of what you can expect from a treatment.

Primary study objectives

Change in Depressive Symptoms as assessed by the PROMIS 57

Change in Depressive Symptoms as assessed by the Patient Health Questionnaire 9 (PHQ-9)

Change in Pain Intensity as assessed by the Patient Reported Outcomes Measurement Information System (PROMIS)

+1 more

Secondary study objectives

Change in Frailty as assessed by the Frail Scale

Change in Frailty as assessed by the Frailty Phenotype measure

Change in Physical Function as assessed by the Katz Activities of daily living (ADL)

+1 more

Other study objectives

Change in Communication with Health Care Providers as assessed by the Patients' Reaction Assessment

Change in Comorbid Conditions as assessed by the Charlson Comorbidity Index

Change in Self Efficacy as assessed by the Coping and Self-Efficacy Scale

+2 more

Awards & Highlights

No Placebo-Only Group

All patients enrolled in this study will receive some form of active treatment.

Trial Design

2Treatment groups

Experimental Treatment

Active Control

Group I: Intervention ArmExperimental Treatment1 Intervention

The intervention group will receive the intervention for 12 weeks. The wait list control group will have outcomes measured but will not receive the intervention at this time.

Group II: Wait List Control ArmActive Control1 Intervention

Once the intervention group has completed the intervention the wait list control group will complete the intervention.

Treatment

First Studied

Drug Approval Stage

How many patients have taken this drug

DAPPER

2020

N/A

~40

0 / 3Eligibility criteria met

Research Highlights

Information in this section is not a recommendation. We encourage patients to speak with their healthcare team when evaluating any treatment decision.

Mechanism Of Action

Side Effect Profile

Prior Approvals

Other Research

Common treatments for depression include pharmacological approaches like SSRIs, SNRIs, and tricyclic antidepressants, which work by adjusting neurotransmitter levels in the brain to improve mood. Non-pharmacological treatments such as Cognitive Behavioral Therapy (CBT) and Behavioral Activation (BA) focus on changing negative thought patterns and increasing engagement in positive activities. Personalized interventions, like the DAPPER study involving nurse visits, address both pain and mood, offering a holistic approach that can be particularly effective for patients with co-occurring physical and mental health issues. Understanding these mechanisms is crucial for tailoring treatments to individual needs, thereby enhancing the overall effectiveness of depression management.

A Feasibility Study of Behavioral Activation for Major Depressive Disorder in a Community Mental Health Setting.A randomized controlled trial of a senior centre group programme for increasing social support and preventing depression in elderly people living at home in Norway.Delineating mechanisms of change in child and adolescent therapy: methodological issues and research recommendations.