Effect of a Collaborative Care Model on Anxiety Symptoms Among Patients with Depression and Diabetes in India: The INDEPENDENT Randomized Clinical Trial
| Autor: | Nikhil Tandon, Viswanathan Mohan, Lydia Chwastiak, Christopher G. Kemp, Aravind Sosale, Mohammed K. Ali, Rajesh Sagar, Ranjit Mohan Anjana, Deepa Rao, K.M.V. Narayan, Gumpeny R. Sridhar, Shivani A. Patel, Leslie Johnson, Subramani Poongothai, Karl M F Emmert-Fees |
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| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
Primary Health Care business.industry Depression Collaborative Care India Anxiety medicine.disease Article law.invention Psychiatry and Mental health Randomized controlled trial Diabetes Mellitus Type 2 law Diabetes mellitus Medicine Humans medicine.symptom business Psychiatry Depression (differential diagnoses) Diabetes Integrated Care |
| Zdroj: | Gen Hosp Psychiatry Gen. Hosp. Psychiatry 74, 39-45 (2022) |
| Popis: | Objective: We assessed the impact of a collaborative care intervention on anxiety symptoms among participants in India with comorbid depression, poorly controlled diabetes, and moderate to severe anxiety symptoms. Method: We analyzed data from a randomized controlled trial conducted at four diabetes clinics in India. Participants received either collaborative care or usual care. We included only participants who scored ⩾10 on the Generalized Anxiety Disorder-7 (GAD-7) at baseline. We estimated the effect of the intervention on clinically significant reduction in anxiety symptoms; we considered several potential baseline moderators and mediation by anti-depressant use. Results: One hundred and seventy-two participants scored 10 or above on the GAD-7 at baseline. Collaborative care participants were more likely than control participants to achieve a clinically significant reduction in anxiety symptoms at 6 and 12 months (65.7% vs. 41.4% at 12 months, p = 0.002); these differences were not sustained at 18 or 24 months. There was little evidence of moderation by participant characteristics at baseline, and effects were not mediated by anti-depressant use. Conclusions: Collaborative care for the treatment of depression and type 2 diabetes can lead to clinically significant reductions in anxiety symptoms among patients with anxiety. Effects were notable during the active intervention period but not over the year post-intervention. |
| Databáze: | OpenAIRE |
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