Improved glycemic control, depression remission with integrated primary care treatment approach
MONDAY, Jan. 16 (HealthDay News) -- Integrating the treatment of type 2 diabetes and depression improves outcomes, including glycemic control and depression, for patients in the primary care setting, according to a study published in the January/February issue of the Annals of Family Medicine.
Hillary R. Bogner, M.D., of the University of Pennsylvania in Philadelphia, and colleagues conducted a randomized controlled trial -- involving 180 primary care patients receiving pharmacotherapy for type 2 diabetes and depression -- to determine whether an integrated treatment approach could improve glycemic control, adherence to medications, and depression symptoms. Patients received either integrated care, which involved additional education and guideline-based treatment recommendations and frequent monitoring of adherence and clinical status, or usual care. Depression was measured using the nine-item Patient Health Questionnaire (PHQ-9); medication adherence was assessed using the Medication Event Monitoring System; and glycated hemoglobin (HbA1c) was used to quantify the patient's level of glycemic control.
The investigators found that, at 12 weeks, 60.9 percent of patients receiving integrated care achieved an HbA1c level of less than 7 percent, compared with 35.7 percent of those who received usual care. Patients in the integrated care group were also more likely to achieve remission of depression, with 58.7 percent scoring less than five on the PHQ-9 questionnaire compared with only 30.7 percent of patients receiving usual care.
"Our results show the usefulness of a simple, brief, integrated care management intervention for primary care patients with type 2 diabetes and depression," the authors write.