TY - JOUR
KW - African Americans/psychology
KW - Aged
KW - Antidepressive Agents/therapeutic use
KW - Depression/blood/complications/drug therapy
KW - Diabetes Mellitus, Type 2/blood/drug therapy/psychology
KW - Female
KW - Hemoglobin A, Glycosylated/metabolism
KW - Humans
KW - Hypoglycemic Agents/therapeutic use
KW - Male
KW - Middle Aged
KW - Patient Compliance
KW - Philadelphia
KW - Pilot Projects
KW - Systems Integration
AU - H. R. Bogner
AU - H. F. de Vries
A1 - 
AB - PURPOSE: The purpose of this study was to examine whether integrating depression treatment into care for type 2 diabetes mellitus among older African Americans improved medication adherence, glycemic control, and depression outcomes. METHODS: Older African Americans prescribed pharmacotherapy for type 2 diabetes mellitus and depression from physicians at a large primary care practice in west Philadelphia were randomly assigned to an integrated care intervention or usual care. Adherence was assessed at baseline, 2, 4, and 6 weeks using the Medication Event Monitoring System to assess adherence. Outcomes assessed at baseline and 12 weeks included standard laboratory tests to measure glycemic control and the Center for Epidemiologic Studies Depression Scale (CES-D) to assess depression. RESULTS: In all, 58 participants aged 50 to 80 years participated. The proportion of participants who had 80% or greater adherence to an oral hypoglycemic (intervention 62.1% vs usual care 24.1%) and an antidepressant (intervention 62.1% vs usual care 10.3%) was greater in the intervention group in comparison with the usual care group at 6 weeks. Participants in the integrated care intervention had lower levels of glycosylated hemoglobin (intervention 6.7% vs usual care 7.9%) and fewer depressive symptoms (CES-D mean scores: intervention 9.6 vs usual care 16.6) compared with participants in the usual care group at 12 weeks. CONCLUSION: A pilot randomized controlled trial integrating type 2 diabetes mellitus treatment and depression was successful in improving outcomes among older African Americans. Integrated interventions may be more feasible and effective in real-world practices with competing demands for limited resources.
BT - The Diabetes educator
C5 - General Literature
CP - 2
CY - United States
DO - 10.1177/0145721709356115
IS - 2
JF - The Diabetes educator
N2 - PURPOSE: The purpose of this study was to examine whether integrating depression treatment into care for type 2 diabetes mellitus among older African Americans improved medication adherence, glycemic control, and depression outcomes. METHODS: Older African Americans prescribed pharmacotherapy for type 2 diabetes mellitus and depression from physicians at a large primary care practice in west Philadelphia were randomly assigned to an integrated care intervention or usual care. Adherence was assessed at baseline, 2, 4, and 6 weeks using the Medication Event Monitoring System to assess adherence. Outcomes assessed at baseline and 12 weeks included standard laboratory tests to measure glycemic control and the Center for Epidemiologic Studies Depression Scale (CES-D) to assess depression. RESULTS: In all, 58 participants aged 50 to 80 years participated. The proportion of participants who had 80% or greater adherence to an oral hypoglycemic (intervention 62.1% vs usual care 24.1%) and an antidepressant (intervention 62.1% vs usual care 10.3%) was greater in the intervention group in comparison with the usual care group at 6 weeks. Participants in the integrated care intervention had lower levels of glycosylated hemoglobin (intervention 6.7% vs usual care 7.9%) and fewer depressive symptoms (CES-D mean scores: intervention 9.6 vs usual care 16.6) compared with participants in the usual care group at 12 weeks. CONCLUSION: A pilot randomized controlled trial integrating type 2 diabetes mellitus treatment and depression was successful in improving outcomes among older African Americans. Integrated interventions may be more feasible and effective in real-world practices with competing demands for limited resources.
PP - United States
PY - 2010
SN - 1554-6063; 0145-7217
SP - 284
EP - 292
EP - 
T1 - Integrating type 2 diabetes mellitus and depression treatment among African Americans: a randomized controlled pilot trial
T2 - The Diabetes educator
TI - Integrating type 2 diabetes mellitus and depression treatment among African Americans: a randomized controlled pilot trial
U1 - General Literature
U2 - 20040705
U3 - 10.1177/0145721709356115
VL - 36
VO - 1554-6063; 0145-7217
Y1 - 2010
ER -