Abstract | PURPOSE: METHODS: We undertook a randomized controlled trial conducted from April 2010 through April 2011 of 180 patients prescribed pharmacotherapy for type 2 diabetes and depression in primary care. Patients were randomly assigned to an integrated care intervention or usual care. Integrated care managers collaborated with physicians to offer education and guideline-based treatment recommendations and to monitor adherence and clinical status. Adherence was assessed using the Medication Event Monitoring System ( MEMS). We used glycated hemoglobin (HbA(1c)) assays to measure glycemic control and the 9-item Patient Health Questionnaire (PHQ-9) to assess depression. RESULTS: Intervention and usual care groups did not differ statistically on baseline measures. Patients who received the intervention were more likely to achieve HbA(1c) levels of less than 7% (intervention 60.9% vs. usual care 35.7%; P < .001) and remission of depression (PHQ-9 score of less than 5: intervention 58.7% vs. usual care 30.7%; P < .001) in comparison with patients in the usual care group at 12 weeks. CONCLUSIONS: A randomized controlled trial of a simple, brief intervention integrating treatment of type 2 diabetes and depression was successful in improving outcomes in primary care. An integrated approach to depression and type 2 diabetes treatment may facilitate its deployment in real-world practices with competing demands for limited resources.
|
Authors | Hillary R Bogner, Knashawn H Morales, Heather F de Vries, Anne R Cappola |
Journal | Annals of family medicine
(Ann Fam Med)
2012 Jan-Feb
Vol. 10
Issue 1
Pg. 15-22
ISSN: 1544-1717 [Electronic] United States |
PMID | 22230826
(Publication Type: Journal Article, Multicenter Study, Randomized Controlled Trial, Research Support, N.I.H., Extramural)
|
Chemical References |
- Antidepressive Agents
- Blood Glucose
- Hypoglycemic Agents
|
Topics |
- Adult
- Aged
- Antidepressive Agents
- Blood Glucose
(analysis)
- Depressive Disorder
(complications, drug therapy)
- Diabetes Mellitus, Type 2
(blood, drug therapy, psychology)
- Female
- Humans
- Hypoglycemic Agents
- Linear Models
- Male
- Medication Adherence
- Middle Aged
- Patient Care Team
- Philadelphia
- Primary Health Care
(methods)
- Psychiatric Status Rating Scales
- Treatment Outcome
|