Alelie. Thanks for setting this up. I will circulate to the team and confirm it’s private. Please add other directions as needed
Here’s feedback from NAMI (Ashley, exec director) & Uni South Florida (Dr. Marie McPherson, head of their Behavioral Health department, with services in 14 counties. Note: USF want to be involved in the TeamMIND hub in some meaningful way; and improving access to care for their population. They have a focus on youth. This was in response to questions about which patients to pick: MH, SUD or both (cooccurring conditions).:
1. Dr Marie said (i) MH (ii) SUD (III) cooccurring conditions (iv) physical health (v) with criminal justice involvement ( she confirmed that’s because this often means PTSD)
2. Ashley said ‘none of the above 🙁 ). Rather, pick those with specific diagnosis (e.g bipolar & opioid addiction), then we are comparing like to like standards of care.
It’s not my place to choose, but Ashley sounded the best choice.
Next I will summarize our call ……
Thoughts……Is it possible to get them together to come to agreement? Did they respond to a written statement about the study proposal or was it more conversational? If not written, then we need to prepare that before pulling them together. again.
Draft Trial Title and Endpoints:
A Randomized, Subject Matched, Open Label trial to Compare Subjects on Team Patient coordinated care vs Standard of Care in participants with co-occurrence of Substance Abuse Disorders(SUD) and Mental Health Illness for Quality of Life Outcomes.
Subjects assigned to Team Patient and Standard of Care will have improved Quality of Life Health Outcomes as compared to subjects with Standard of Care only.
(Study Design note: Each randomized subject group pair will be provided a Navigator (Social case worker) to follow subjects with or without Team Patient and assist with Study Data collection in that subject matched group)
Additional potential endpoints:
Subjects on Team Patient had fewer: 1) Relapses
2) emergency room/hospital visits
3) healthcare dollar cost
as compared to Standard of care only.
Subjects on Team Patient had improved: 1) Compliance to treatment goals and medication
2) Length of recovery times(Months)
3) Improved social interactions (family, peers,friends)
4) overall functioning in society( new employment,
community volunteering, self supporting)
as compared to Standard of Care only.
Further discussion needed also on what questions/test forms are used to measure each of the studies endpoints.
Thanks Sheri, Bruce.
Sheri: this was conversational, and I think Dr. Marie spoke without a proper context, and without regard to our goals; and Ashley spoke from a personal, experiential perspective,
Bruce: you preempted some of my transcription work (thanks!); I will now review the video of our call and report back any relevant comments.
Firstly, thanks again Bruce for conceiving the overview and writing up the key notes. I reviewed the video a few times from our call and tried to summarize action steps by merging comments from the call and what Bruce had written. I am out of my comfort zone here, but tried to capture below what I observed: as to next steps. We must:
1. finalize the study title. …..this seems to me to be complete and comprehensive
2. agree the primary endpoint. … this looks very good to me, as it wraps in a navigator as part of the solution, to address “what is TeamPatient”
3. create the study design
4. agree secondary endpoints … and that must include healthcare costs
5. define ‘standard of care’ … by using the same doctors in the matches, that will simplify that definition, as we can confirm with the docs. I will talk with Ashley to (try and) get a starting dialog with the OBGY doctor in Volusia
6. define population target(s) ….I will ask Ashley again, but I liked her first answer: diagnoses define the population e.g., bi-polar diagnosis, using heroin. I like keeping it narrow and deep, therefore simple. And I like keeping the study on say OBGY….it should be one of the best tests for coordination, because there are so many multi-disciplinary touchpoints, an urgency not in other populations, more likely attendance at the physician (than other diagnoses), and a great cost impact (with a child under review for up to 2 years for things like Neonatal abstinence syndrome).
7. define quality measures
I will now work on next steps!
This is really exhilarating, and supported by comments Keith has been sending this weekend from a conference he is attending that says ‘we’re definitely’ on the right track.
Grazie mille. Peter
I am also reminded about data:
1. NAMI want us to include BARC-10 evaluations, as it relates to SDOH
2. Bruce had suggested capturing 5 questions from doctors in the data we capture.
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