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Collaborative Care Management of Major Depression Among Low-Income, Predominantly Hispanic Subjects With Diabetes: A randomized controlled trial

OBJECTIVE: To determine whether evidence-based socioculturally adapted collaborative depression care improves receipt of depression care and depression and diabetes outcomes in low-income Hispanic subjects. RESEARCH DESIGN AND METHODS: This was a randomized controlled trial of 387 diabetic patients...

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Autores principales: Ell, Kathleen, Katon, Wayne, Xie, Bin, Lee, Pey-Jiuan, Kapetanovic, Suad, Guterman, Jeffrey, Chou, Chih-Ping
Formato: Texto
Lenguaje:English
Publicado: American Diabetes Association 2010
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2845010/
https://www.ncbi.nlm.nih.gov/pubmed/20097780
http://dx.doi.org/10.2337/dc09-1711
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author Ell, Kathleen
Katon, Wayne
Xie, Bin
Lee, Pey-Jiuan
Kapetanovic, Suad
Guterman, Jeffrey
Chou, Chih-Ping
author_facet Ell, Kathleen
Katon, Wayne
Xie, Bin
Lee, Pey-Jiuan
Kapetanovic, Suad
Guterman, Jeffrey
Chou, Chih-Ping
author_sort Ell, Kathleen
collection PubMed
description OBJECTIVE: To determine whether evidence-based socioculturally adapted collaborative depression care improves receipt of depression care and depression and diabetes outcomes in low-income Hispanic subjects. RESEARCH DESIGN AND METHODS: This was a randomized controlled trial of 387 diabetic patients (96.5% Hispanic) with clinically significant depression recruited from two public safety-net clinics from August 2005 to July 2007 and followed over 18 months. Intervention (INT group) included problem-solving therapy and/or antidepressant medication based on a stepped-care algorithm; first-line treatment choice; telephone treatment response, adherence, and relapse prevention follow-up over 12 months; plus systems navigation assistance. Enhanced usual care (EUC group) included standard clinic care plus patient receipt of depression educational pamphlets and a community resource list. RESULTS: INT patients had significantly greater depression improvement (≥50% reduction in Symptom Checklist-20 depression score from baseline; 57, 62, and 62% vs. the EUC group's 36, 42, and 44% at 6, 12, and 18 months, respectively; odds ratio 2.46–2.57; P < 0.001). Mixed-effects linear regression models showed a significant study group–by–time interaction over 18 months in diabetes symptoms; anxiety; Medical Outcomes Study Short-Form Health Survey (SF-12) emotional, physical, and pain-related functioning; Sheehan disability; financial situation; and number of social stressors (P = 0.04 for disability and SF-12 physical functioning, P < 0.001 for all others) but no study group–by–time interaction in A1C, diabetes complications, self-care management, or BMI. CONCLUSIONS: Socioculturally adapted collaborative depression care improved depression, functional outcomes, and receipt of depression treatment in predominantly Hispanic patients in safety-net clinics.
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spelling pubmed-28450102011-04-01 Collaborative Care Management of Major Depression Among Low-Income, Predominantly Hispanic Subjects With Diabetes: A randomized controlled trial Ell, Kathleen Katon, Wayne Xie, Bin Lee, Pey-Jiuan Kapetanovic, Suad Guterman, Jeffrey Chou, Chih-Ping Diabetes Care Original Research OBJECTIVE: To determine whether evidence-based socioculturally adapted collaborative depression care improves receipt of depression care and depression and diabetes outcomes in low-income Hispanic subjects. RESEARCH DESIGN AND METHODS: This was a randomized controlled trial of 387 diabetic patients (96.5% Hispanic) with clinically significant depression recruited from two public safety-net clinics from August 2005 to July 2007 and followed over 18 months. Intervention (INT group) included problem-solving therapy and/or antidepressant medication based on a stepped-care algorithm; first-line treatment choice; telephone treatment response, adherence, and relapse prevention follow-up over 12 months; plus systems navigation assistance. Enhanced usual care (EUC group) included standard clinic care plus patient receipt of depression educational pamphlets and a community resource list. RESULTS: INT patients had significantly greater depression improvement (≥50% reduction in Symptom Checklist-20 depression score from baseline; 57, 62, and 62% vs. the EUC group's 36, 42, and 44% at 6, 12, and 18 months, respectively; odds ratio 2.46–2.57; P < 0.001). Mixed-effects linear regression models showed a significant study group–by–time interaction over 18 months in diabetes symptoms; anxiety; Medical Outcomes Study Short-Form Health Survey (SF-12) emotional, physical, and pain-related functioning; Sheehan disability; financial situation; and number of social stressors (P = 0.04 for disability and SF-12 physical functioning, P < 0.001 for all others) but no study group–by–time interaction in A1C, diabetes complications, self-care management, or BMI. CONCLUSIONS: Socioculturally adapted collaborative depression care improved depression, functional outcomes, and receipt of depression treatment in predominantly Hispanic patients in safety-net clinics. American Diabetes Association 2010-04 2010-01-22 /pmc/articles/PMC2845010/ /pubmed/20097780 http://dx.doi.org/10.2337/dc09-1711 Text en © 2010 by the American Diabetes Association. https://creativecommons.org/licenses/by-nc-nd/3.0/Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered. See http://creativecommons.org/licenses/by-nc-nd/3.0/ (https://creativecommons.org/licenses/by-nc-nd/3.0/) for details.
spellingShingle Original Research
Ell, Kathleen
Katon, Wayne
Xie, Bin
Lee, Pey-Jiuan
Kapetanovic, Suad
Guterman, Jeffrey
Chou, Chih-Ping
Collaborative Care Management of Major Depression Among Low-Income, Predominantly Hispanic Subjects With Diabetes: A randomized controlled trial
title Collaborative Care Management of Major Depression Among Low-Income, Predominantly Hispanic Subjects With Diabetes: A randomized controlled trial
title_full Collaborative Care Management of Major Depression Among Low-Income, Predominantly Hispanic Subjects With Diabetes: A randomized controlled trial
title_fullStr Collaborative Care Management of Major Depression Among Low-Income, Predominantly Hispanic Subjects With Diabetes: A randomized controlled trial
title_full_unstemmed Collaborative Care Management of Major Depression Among Low-Income, Predominantly Hispanic Subjects With Diabetes: A randomized controlled trial
title_short Collaborative Care Management of Major Depression Among Low-Income, Predominantly Hispanic Subjects With Diabetes: A randomized controlled trial
title_sort collaborative care management of major depression among low-income, predominantly hispanic subjects with diabetes: a randomized controlled trial
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2845010/
https://www.ncbi.nlm.nih.gov/pubmed/20097780
http://dx.doi.org/10.2337/dc09-1711
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