Collaborative Depression Care Among Latino Patients in Diabetes Disease Management, Los Angeles, 2011–2013
| Autor: | Pey-Jiuan Lee, Kathleen Ell, Brian Wu, Shinyi Wu, Haomiao Jin, Irene Vidyanti |
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| Rok vydání: | 2014 |
| Předmět: |
Male
Comparative Effectiveness Research medicine.medical_specialty Evidence-based practice Comparative effectiveness research MEDLINE Comorbidity Translational Research Biomedical Diabetes Mellitus Humans Medicine Registries Healthcare Disparities Disease management (health) Depression (differential diagnoses) Original Research Patient Care Team Depressive Disorder Delivery of Health Care Integrated business.industry Health Policy Public Health Environmental and Occupational Health Hispanic or Latino Middle Aged medicine.disease Los Angeles Patient Care Management 3. Good health Clinical trial Latin America Treatment Outcome Evidence-Based Practice Family medicine Propensity score matching Linear Models Female business Safety-net Providers |
| Zdroj: | Preventing Chronic Disease |
| ISSN: | 1545-1151 |
| DOI: | 10.5888/pcd11.140081 |
| Popis: | Introduction The prevalence of comorbid diabetes and depression is high, especially in low-income Hispanic or Latino patients. The complex mix of factors in safety-net care systems impedes the adoption of evidence-based collaborative depression care and results in persistent disparities in depression outcomes. The Diabetes-Depression Care-Management Adoption Trial examined whether the collaborative depression care model is an effective approach in safety-net clinics to improve clinical care outcomes of depression and diabetes. Methods A sample of 964 patients with diabetes from 5 safety-net clinics were enrolled in a quasi-experimental study that included 2 arms: usual care, in which primary medical providers and staff translated and adopted evidence-based depression care; and supportive care, in which providers of a disease management program delivered protocol-driven depression care. Because the study design established individual treatment centers as separate arms, we calculated propensity scores that interpreted the probability of treatment assignment conditional on observed baseline characteristics. Primary outcomes were 5 depression care outcomes and 7 diabetes care measures. Regression models with propensity score covariate adjustment were applied to analyze 6-month outcomes. Results Compared with usual care, supportive care significantly decreased Patient Health Questionnaire-9 scores, reduced the number of patients with moderate or severe depression, improved depression remission, increased satisfaction in care for patients with emotional problems, and significantly reduced functional impairment. Conclusion Implementing collaborative depression care in a diabetes disease management program is a scalable approach to improve depression outcomes and patient care satisfaction among patients with diabetes in a safety-net care system. |
| Databáze: | OpenAIRE |
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