Post-stroke depression (PSD) is a prevalent condition that has pervasive effects on patients' functional recovery and health-related quality of life (HRQOL), as well as outcomes of caregivers. The long-term objective of this proposal is to evaluation the effectiveness of a multi-faceted, 12 week intervention (AIM) that seeks to activate patients to be aware of PSD, initiate antidepressant treatment, and monitor treatment side effects and compliance.
The specific aims are to improve: 1) depression symptoms, and 2) stroke-specific quality of life outcomes in patients with PSD. We will enroll 244 ischemic stroke patients who exhibit PSD 1 month post-stroke and randomize them to the AIM intervention vs. usual care. Patients received standardized assessments based on a conceptual framework of stress and coping. Variables include social support, stroke severity, depression, HRQOL, life satisfaction and functional outcomes. Primary depression outcomes are determined 3 months following randomization. We will also examine the durability of the intervention by comparing outcomes at 9 months following randomization. The study protocol requires assembly of a prospective cohort of ischemic stroke patients with and without PSD. Thus, a secondary objective of this study is to capitalize on this opportunity by assessing outcomes in non-depressed stroke survivors (n=244) and stroke caregivers (n=340). These secondary aims are to evaluate the effects of PSD by comparing: 1) outcomes in depressed and non-depressed patients, and 2) in caregivers of depressed and non-depressed patients. Secondary analyses will use the rich post-stroke database to evaluate longitudinal depression and HRQOL outcomes in patients and caregivers, examine the relationship of patient and caregiver outcomes post-stroke, and compare the health care utilization of patients with and without PSD.

Agency
National Institute of Health (NIH)
Institute
National Institute of Neurological Disorders and Stroke (NINDS)
Type
Research Project (R01)
Project #
5R01NS039571-04
Application #
6603225
Study Section
Special Emphasis Panel (ZRG1-RPHB-3 (01))
Program Officer
Marler, John R
Project Start
2000-09-30
Project End
2005-06-30
Budget Start
2003-07-01
Budget End
2005-06-30
Support Year
4
Fiscal Year
2003
Total Cost
$473,264
Indirect Cost
Name
Indiana University-Purdue University at Indianapolis
Department
Neurology
Type
Schools of Medicine
DUNS #
603007902
City
Indianapolis
State
IN
Country
United States
Zip Code
46202
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