TY - JOUR
AU - J. D. Piette
AU - C. Richardson
AU - J. Himle
AU - S. Duffy
AU - T. Torres
AU - M. Vogel
AU - K. Barber
AU - M. Valenstein
A1 - 
AB - Abstract. Background: Patients with diabetes and depression often have self-management needs that require between-visit support. This study evaluated the impact of telephone-delivered cognitive behavioral therapy (CBT) targeting patients� management of depressive symptoms, physical activity levels, and diabetes-related outcomes. Methods: 291 patients with type 2 diabetes and significant depressive symptoms (Beck Depression Inventory scores ?14)were recruited from a community-university-and VA healthcare system. A manualized telephone CBT program was delivered by nurses weekly for 12weeks, followed by nine monthly booster sessions. Sessions initially focused exclusively on patients� depression management and then added a pedometer-based walking program. The primary outcome was hemoglobin A1cmeasured at 12-months. Blood pressure was a secondary outcome; levels of physical activity were determined by pedometer readings; depression, coping, and health related quality of life (HRQL) were measured using standardized scales. Results: Baseline A1c levels were relatively good and there was no difference in A1c at follow-up. Intervention patients experienced a4.26 mmHg decrease in systolic blood pressure relative to controls (p=.05). Intervention patients had significantly greater increases in step-counts (mean difference 1,131 steps/day; p=.0002) and greater reductions in depressive symptoms (58%remitted at12 months versus 39%; p=.002). Intervention patients also experienced relative improvements in coping and HRQL. Conclusions: This program of telephone delivered CBT combined with a pedometer-based walking program did not improve A1c values but significantly decreased patients� blood pressure, increased physical activity, and decreased depressive symptoms. The intervention also improved patients� functioning and quality of life.
BT - Medical Care
C5 - General Literature
CP - 7
DO - 10.1097/MLR.0b013e318215d0c9
IS - 7
JF - Medical Care
N2 - Abstract. Background: Patients with diabetes and depression often have self-management needs that require between-visit support. This study evaluated the impact of telephone-delivered cognitive behavioral therapy (CBT) targeting patients� management of depressive symptoms, physical activity levels, and diabetes-related outcomes. Methods: 291 patients with type 2 diabetes and significant depressive symptoms (Beck Depression Inventory scores ?14)were recruited from a community-university-and VA healthcare system. A manualized telephone CBT program was delivered by nurses weekly for 12weeks, followed by nine monthly booster sessions. Sessions initially focused exclusively on patients� depression management and then added a pedometer-based walking program. The primary outcome was hemoglobin A1cmeasured at 12-months. Blood pressure was a secondary outcome; levels of physical activity were determined by pedometer readings; depression, coping, and health related quality of life (HRQL) were measured using standardized scales. Results: Baseline A1c levels were relatively good and there was no difference in A1c at follow-up. Intervention patients experienced a4.26 mmHg decrease in systolic blood pressure relative to controls (p=.05). Intervention patients had significantly greater increases in step-counts (mean difference 1,131 steps/day; p=.0002) and greater reductions in depressive symptoms (58%remitted at12 months versus 39%; p=.002). Intervention patients also experienced relative improvements in coping and HRQL. Conclusions: This program of telephone delivered CBT combined with a pedometer-based walking program did not improve A1c values but significantly decreased patients� blood pressure, increased physical activity, and decreased depressive symptoms. The intervention also improved patients� functioning and quality of life.
PY - 2011
SP - 641
EP - 648
EP - 
T1 - A randomized trial of telephonic counseling plus walking for depressed diabetes patients
T2 - Medical Care
TI - A randomized trial of telephonic counseling plus walking for depressed diabetes patients
U1 - General Literature
U2 - 21478777
U3 - 10.1097/MLR.0b013e318215d0c9
VL - 49
Y1 - 2011
ER -