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Randomized Controlled Trial
. 2010 Apr;33(4):706-13.
doi: 10.2337/dc09-1711. Epub 2010 Jan 22.

Collaborative care management of major depression among low-income, predominantly Hispanic subjects with diabetes: a randomized controlled trial

Kathleen Ell  1 , Wayne Katon, Bin Xie, Pey-Jiuan Lee, Suad Kapetanovic, Jeffrey Guterman, Chih-Ping Chou
Affiliations
Randomized Controlled Trial

Collaborative care management of major depression among low-income, predominantly Hispanic subjects with diabetes: a randomized controlled trial

Kathleen Ell et al. Diabetes Care. 2010 Apr.

Abstract

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 (> or =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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Figures

Figure 1
Figure 1
Study consort chart.
See this image and copyright information in PMC

References

    1. Li C, Ford ES, Strine TW, Mokdad AH. Prevalence of depression among U.S. adults with diabetes: findings from the 2006 behavioral risk factor surveillance system. Diabetes Care 2008;31:105–107 - PubMed
    1. Lanting LC, Joung I, Mackenbach JP, Lamberts SW, Boostma AH. Ethnic differences in mortality, end-stage complications, and quality of care among diabetic patients. Diabetes Care 2005;28:2280–2288 - PubMed
    1. Gross R, Olfson M, Gameroff MJ, Carasquillo O, Shea S, Feder A, Lantigua R, Fuentes M, Weissman MM. Depression and glycemic control in Hispanic primary care patients with diabetes. J Gen Intern Med 2005;20:460–466 - PMC - PubMed
    1. Pinto-Meza A, Fernandez A, Serrano-Blanco A, Haro JM. Adequacy of antidepressant treatment in Spanish primary care: a naturalistic six-month follow-up study. Psychiatr Serv 2008;59:78–83 - PubMed
    1. Kirk JK, Passmore LV, Bell RA, Narayan KM, D'Agostino RB, Jr, Arcury TA, Quandt SA. Disparities in A1C levels between Hispanic and non-Hispanic white adults with diabetes: a meta-analysis. Diabetes Care 2008;31:240–246 - PubMed

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