Cargando…
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...
Autores principales: | , , , , , , |
---|---|
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 |
_version_ | 1782179354454786048 |
---|---|
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. |
format | Text |
id | pubmed-2845010 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2010 |
publisher | American Diabetes Association |
record_format | MEDLINE/PubMed |
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 |
work_keys_str_mv | AT ellkathleen collaborativecaremanagementofmajordepressionamonglowincomepredominantlyhispanicsubjectswithdiabetesarandomizedcontrolledtrial AT katonwayne collaborativecaremanagementofmajordepressionamonglowincomepredominantlyhispanicsubjectswithdiabetesarandomizedcontrolledtrial AT xiebin collaborativecaremanagementofmajordepressionamonglowincomepredominantlyhispanicsubjectswithdiabetesarandomizedcontrolledtrial AT leepeyjiuan collaborativecaremanagementofmajordepressionamonglowincomepredominantlyhispanicsubjectswithdiabetesarandomizedcontrolledtrial AT kapetanovicsuad collaborativecaremanagementofmajordepressionamonglowincomepredominantlyhispanicsubjectswithdiabetesarandomizedcontrolledtrial AT gutermanjeffrey collaborativecaremanagementofmajordepressionamonglowincomepredominantlyhispanicsubjectswithdiabetesarandomizedcontrolledtrial AT chouchihping collaborativecaremanagementofmajordepressionamonglowincomepredominantlyhispanicsubjectswithdiabetesarandomizedcontrolledtrial |