Behavioral Activation and Medication Optimization for Perioperative Mental Health Feasibility Study

Summary

Inadequate management of preoperative mental health disorders often contributes to poor postoperative outcomes, including increased rates of readmission, delirium, falls, and mortality. However, very little work has been done to improve perioperative mental health. In particular, there have been limited systematic efforts that identify evidence-based behavioral and pharmacological strategies that were originally developed for depression and anxiety in otherwise medically well psychiatric patients. A mental health intervention bundle, composed of behavioral and pharmacological strategies, can mitigate anxiety and depression symptoms during the perioperative period. However, lacking is conclusive evidence on effectiveness of such an intervention bundle focused on the delivery of perioperative mental health care in older surgical patients. Towards this end, the investigators will develop and test an intervention bundle that encompasses: (1) behavioral activation, and (2) medication optimization.

Conditions

• Older Adults
• Anxiety
• Depression
• Cardiac Surgery
• Orthopedic Surgery
• Major Surgical Resection of a Thoracic Malignancy
• Major Surgical Resection of an Abdominal Malignancy

Interventions

BEHAVIORAL

Behavioral Activation

The behavioral intervention will consist of behavioral activation (BA), the basic premise of which is to help people with mental health problems to engage in activities that are reinforcing or meaningful and guided by their personal values

OTHER

Medication Optimization

Medication optimization consists of a simple set of principles: reconcile patient's medications, identify the patient's likely need for, and interest in, a medication adjustment, make the adjustment, and assess the response to that adjustment.

Sponsors & Collaborators

• National Institute of Mental Health (NIMH)

  collaborator NIH

• Washington University School of Medicine

  lead OTHER

Principal Investigators

• Michael Avidan, MBBCh, FCASA · Washington University School of Medicine

Study Design

Allocation

NA

Purpose

TREATMENT

Masking

NONE

Model

SINGLE_GROUP

Eligibility

Min Age

60 Years

Sex

ALL

Healthy Volunteers

No

Timeline & Regulatory

Start

2021-11-17

Primary Completion

2022-12-22

Completion

2022-12-22

Countries

• United States

Study Locations