Clinical complexity and the effectiveness of an intervention for depressed diabetes patients
| Autor: | John D. Piette, Marcia Valenstein, Caroline R. Richardson, Trissa Torres, Joseph A. Himle, Mark Vogel, Sonia A. Duffy |
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| Rok vydání: | 2011 |
| Předmět: |
Male
medicine.medical_specialty medicine.medical_treatment Article law.invention Randomized controlled trial law Surveys and Questionnaires Intervention (counseling) Diabetes mellitus Outcome Assessment Health Care Health care Diabetes Mellitus medicine Humans Depression (differential diagnoses) Aged Cognitive Behavioral Therapy Depression business.industry Health Policy General Medicine Middle Aged medicine.disease Comorbidity Telephone Cognitive behavioral therapy Cognitive therapy Physical therapy Female business |
| Zdroj: | Chronic Illness. 7:267-278 |
| ISSN: | 1745-9206 1742-3953 |
| DOI: | 10.1177/1742395311409259 |
| Popis: | Objectives: In a trial completed in 2010, US patients with diabetes and depression were randomized to usual care or telephone cognitive behavioural therapy that emphasized physical activity. Twelve-month intervention effects were observed for blood pressure, depression, and pedometer-measured step-counts. This study examined variation in intervention effects across patient subgroups defined by a measure of clinical complexity. Methods: Three groups of patients were identified at baseline using the Vector Model of Complexity that recognizes socioeconomic, biological, behavioural, and other determinants of treatment response. Complexity-by-intervention interactions were examined using regression models. Results: Intervention effects for blood pressure, depression, and step-counts differed across complexity levels (each p Conclusions: This intervention had varying impacts on physical and mental health depending on patients' clinical complexity. Physical activity and depressive symptom gains may be more likely among less complex patients, although more complex patients may achieve cardiovascular benefits through decreased blood pressures. |
| Databáze: | OpenAIRE |
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