Collaborative care for patients with depression and diabetes mellitus: a systematic review and meta-analysisReportar como inadecuado

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BMC Psychiatry

, 13:260

Mood disorders


BackgroundDiabetic patients with depression are often inadequately treated within primary care. These comorbid conditions are associated with poor outcomes. The aim of this systematic review was to examine whether collaborative care can improve depression and diabetes outcomes in patients with both depression and diabetes.

MethodsMedline, Embase, Cochrane library and PsyINFO were systematically searched to identify relevant publications. All randomized controlled trials of collaborative care for diabetic patients with depression of all ages who were reported by depression treatment response, depression remission, hemoglobin A1c HbA1c values, adherence to antidepressant medication and-or oral hypoglycemic agent were included. Two authors independently screened search results and extracted data from eligible studies. Dichotomous and continuous measures of outcomes were combined using risk ratios RRs and mean differences MDs with 95% confidence intervals CIs either by fixed or random-effects models.

ResultsEight studies containing 2,238 patients met the inclusion criteria. Collaborative care showed a significant improvement in depression treatment response RR = 1.33, 95% CI = 1.05-1.68, depression remission adjusted RR = 1.53, 95% CI =1.11-2.12, higher rates of adherence to antidepressant medication RR = 1.79, 95% CI = 1.19-2.69 and oral hypoglycemic agent RR = 2.18, 95% CI = 1.61-2.96, but indicated a non-significant reduction in HbA1c values MD = -0.13, 95% CI = -0.46-0.19.

ConclusionsImproving depression care in diabetic patients is very necessary and important. Comparing with usual care, collaborative care was associated with significantly better depressive outcomes and adherence in patients with depression and diabetes. These findings emphasize the implications for collaborative care of diabetic patients with depression in the future.

KeywordsCollaborative care Depression Diabetes mellitus Systematic review Meta-analysis Electronic supplementary materialThe online version of this article doi:10.1186-1471-244X-13-260 contains supplementary material, which is available to authorized users.

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Autor: Yafang Huang - Xiaoming Wei - Tao Wu - Rui Chen - Aimin Guo


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