Thrive Intervention for Mental Illness
(THRIVE-SMI Trial)
Recruiting in Palo Alto (17 mi)
Overseen byJacqueline M Brooks Carthon, PhD,RN
Age: 18+
Sex: Any
Travel: May Be Covered
Time Reimbursement: Varies
Trial Phase: Academic
Recruiting
Sponsor: University of Pennsylvania
Disqualifiers: Under age 18
No Placebo Group
Approved in 1 Jurisdiction
Trial Summary
What is the purpose of this trial?This study aims to evaluate the THRIVE clinical pathway at HUP-Cedar, focusing on supporting Medicaid-insured individuals, including those with serious mental illness, following hospitalization. The study will assess clinician/administrator perspectives on the pathway's feasibility, appropriateness, and acceptability and analyze referral patterns and post-discharge outcomes.
The objectives are:
1. To conduct a qualitative study evaluating the implementation of THRIVE, particularly its adaptation to include patients with serious mental illness.
2. To examine referral patterns, 30-day readmission rates, and ED utilization for THRIVE participants, comparing them with those receiving standard care.
Participants will be referred to home care services during hospitalization and seen by a home care nurse within 48 hours post-discharge. A discharging physician or Advanced Practice Provider will oversee care for 30 days or until a primary care or specialist visit. The Care Coordination Team will hold weekly case conferences for 30 days post-discharge to address both health and mental health needs. The study will compare outcomes of Medicaid-insured patients, including those with serious mental illness, to those receiving usual care.
Will I have to stop taking my current medications?
The trial information does not specify whether you need to stop taking your current medications. It's best to discuss this with the trial coordinators or your doctor.
What data supports the effectiveness of the Thrive Intervention treatment for mental illness?
The i-THRIVE model, which is part of the Thrive Intervention, has been used in over 70 areas in England to improve child and adolescent mental health services by providing a more integrated and needs-led service model. This approach has shown potential to increase access and involvement of patients with services, suggesting it could be effective for mental illness treatment.
12345How is the Thrive Intervention for Mental Illness different from other treatments?
The Thrive Intervention is unique because it uses a peer-led approach, where individuals with similar experiences guide patients in managing their health and accessing care. This method focuses on improving self-management and healthcare utilization, which is different from traditional treatments that may not emphasize peer support and navigation.
36789Eligibility Criteria
This trial is for adults with Medicaid insurance in Pennsylvania who have been hospitalized and agree to home care. It's designed to help those, especially with serious mental illness, transition after hospitalization.Inclusion Criteria
I am covered by Medicaid.
Residing in the state of Pennsylvania
Experienced a hospitalization at study hospital
+1 more
Exclusion Criteria
I am under 18 years old.
Trial Timeline
Screening
Participants are screened for eligibility to participate in the trial
2-4 weeks
Treatment
Participants receive intensive post-discharge case management and care coordination through the THRIVE intervention
4 weeks
Weekly case conferences
Follow-up
Participants are monitored for safety and effectiveness after treatment, including tracking of readmissions and ED visits
30 days
Qualitative Study
Interviews conducted to gather perceptions of the THRIVE clinical pathway and identify barriers and facilitators
18 months
Participant Groups
The THRIVE clinical pathway is being tested. It includes a home care nurse visit within 48 hours of discharge and ongoing care coordination for 30 days, aiming to reduce readmissions and emergency visits compared to standard care.
2Treatment groups
Experimental Treatment
Active Control
Group I: THRIVE InterventionExperimental Treatment1 Intervention
THRIVE Intervention
1-month intensive post discharge case management and care coordination
Group II: Usual CareActive Control1 Intervention
Discharge to home without intensive post-acute case management or care coordination.
Find a Clinic Near You
Research Locations NearbySelect from list below to view details:
Upenn School of Nursing Centre For Health Outcomes Policy ResearchPhiladelphia, PA
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Who Is Running the Clinical Trial?
University of PennsylvaniaLead Sponsor
Agency for Healthcare Research and Quality (AHRQ)Collaborator
References
A protocol for a multi-site cohort study to evaluate child and adolescent mental health service transformation in England using the i-THRIVE model. [2023]The National i-THRIVE Programme seeks to evaluate the impact of the NHS England-funded whole system transformation on child and adolescent mental health services (CAMHS). This article reports on the design for a model of implementation that has been applied in CAMHS across over 70 areas in England using the 'THRIVE' needs-based principles of care. The implementation protocol in which this model, 'i-THRIVE' (implementing-THRIVE), will be used to evaluate the effectiveness of the THRIVE intervention is reported, together with the evaluation protocol for the process of implementation. To evaluate the effectiveness of i-THRIVE to improve care for children and young people's mental health, a cohort study design will be conducted. N = 10 CAMHS sites that adopt the i-THRIVE model from the start of the NHS England-funded CAMHS transformation will be compared to N = 10 'comparator sites' that choose to use different transformation approaches within the same timeframe. Sites will be matched on population size, urbanicity, funding, level of deprivation and expected prevalence of mental health care needs. To evaluate the process of implementation, a mixed-methods approach will be conducted to explore the moderating effects of context, fidelity, dose, pathway structure and reach on clinical and service level outcomes. This study addresses a unique opportunity to inform the ongoing national transformation of CAMHS with evidence about a popular new model for delivering children and young people's mental health care, as well as a new implementation approach to support whole system transformation. If the outcomes reflect benefit from i-THRIVE, this study has the potential to guide significant improvements in CAMHS by providing a more integrated, needs-led service model that increases access and involvement of patients with services and in the care they receive.
Evaluating changes in symptoms and functioning of dually diagnosed clients in specialized treatment. [2019]The authors outline a minimal set of outcome indicators to assess the effects of specialized treatment for people with severe mental illness and substance use disorders and report on use of these indicators in a longitudinal study of such treatments.
Service Use by Medicaid Recipients With Serious Mental Illness During an RCT of the Bridge Peer Health Navigator Intervention. [2021]Integration of general medical care and mental health care is a high priority for individuals with serious mental illnesses because of their high risk of morbidity and early mortality. The Bridge is a peer-led, health navigator intervention designed to improve access to and use of health care and self-management of medical services by individuals with serious mental illnesses. This study expands on a previous study in which the authors examined participants' self-reported outcomes from a 12-month randomized controlled trial of the Bridge. In the study reported here, Medicaid data were used to assess the impact of the intervention on service use during that trial.
American Association of Community Psychiatrists' principles for managing transitions in behavioral health services. [2007]Continuous engagement in treatment and recovery services is one of the most important aspects of addressing acute episodes of severe behavioral health problems and the ongoing disabilities associated with them. Traditionally, fragmentation in systems of care has been common, and the transition from one provider, location, or intensity of service to another has not been prioritized in treatment planning. The authors describe a set of guidelines for maintaining continuity of care that was developed by the American Association of Community Psychiatrists. These guidelines embrace a progressive conceptualization of an integrated service system. For each element of the guidelines, a sample outcome indicator is presented that could be used to measure implementation. These guidelines can be used to help form transition plans, quality improvement initiatives, and program evaluations.
Effect of a mental health "carve-out" program on the continuity of antipsychotic therapy. [2019]On July 1, 1996, as a cost-containment strategy, Tennessee's expanded Medicaid program, TennCare, rapidly shifted the provision of mental health services to a fully capitated, specialty "carve-out" program, TennCare Partners. We studied the effect of this transition on the continuity of antipsychotic therapy among patients with severe mental illness who had previously adhered to treatment.
Connected Care: improving outcomes for adults with serious mental illness. [2018]To evaluate the effectiveness of Connected Care-a care coordination effort of physical and behavioral health managed care partners in Pennsylvania-on acute service use among adult Medicaid beneficiaries with serious mental illness (SMI).
A pilot test of a peer navigator intervention for improving the health of individuals with serious mental illness. [2022]Individuals with serious mental illness (SMI) are at considerably higher risk for morbidity and mortality than those in the general population. The current pilot trial is a preliminary examination of a peer health navigation intervention for improving health and healthcare utilization called the Bridge. Twenty-four individuals with SMI were randomly assigned to either peer navigation or treatment as usual (TAU). Navigators encouraged development of self-management of healthcare through a series of psychoeducation and behavioral strategies. Outcomes included a range of health consequences, as well as health utilization indices. After 6 months, compared to the TAU group, participants receiving the intervention experienced fewer pain and health symptoms. Participants changed their orientation about seeking care to a primary care provider (44.4 % vs. 83.3 %, χ(2) = 3.50, p
Transition of Care for Individuals with Mental Disorders in Brazil: A Contextual Analysis. [2023]To describe the contexts of care transition for individuals with mental disorders in the Brazilian setting.
The Effects of the Transition From Medicaid to Medicare on Health Care Use for Adults With Mental Illness. [2019]The transition from Medicaid-only to dual Medicare/Medicaid coverage has the potential to reduce financial barriers to health care for patients with serious mental illness through increased coverage or expanded access to clinicians as their reimbursement increases.