Gilmer Todd P, Walker Chris, Johnson Elizabeth D, Philis-Tsimikas Athena, Unützer Jürgen
Department of Family and Preventive Medicine, University of California, San Diego, La Jolla, California, USA.
Diabetes Care. 2008 Jul;31(7):1324-6. doi: 10.2337/dc08-0307. Epub 2008 Mar 20.
To assess the feasibility and cost of integrating diabetes and depression care management in three community clinics serving a low-income and predominantly Spanish-speaking Latino population.
We screened diabetes patients for depression, and for those with depressive symptoms, we provided depression care management. We assessed changes in depressive symptoms using the Patient Health Questionnaire-9 (PHQ-9), diabetes self-care activities (nutrition, exercise, and medication adherence), and costs.
Thirty-three percent of patients with diabetes had symptoms of major depression. Among 99 patients completing the study, PHQ-9 scores declined by an average of 7.5 points from 14.8 to 7.3 (P < 0.001). Clients averaged 6.7 visits with the care manager during the study period. Costs of depression care management were estimated to be $512 per participant.
Adding a depression care manager to an existing diabetes management team was effective at reducing depressive symptoms at a reasonable cost.
评估在三家为低收入且主要讲西班牙语的拉丁裔人群服务的社区诊所中整合糖尿病和抑郁症护理管理的可行性及成本。
我们对糖尿病患者进行抑郁症筛查，对于有抑郁症状的患者，我们提供抑郁症护理管理。我们使用患者健康问卷-9（PHQ-9）、糖尿病自我护理活动（营养、运动和药物依从性）以及成本来评估抑郁症状的变化。
33%的糖尿病患者有重度抑郁症状。在完成研究的99名患者中，PHQ-9评分平均从14.8分降至7.3分，下降了7.5分（P<0.001）。在研究期间，患者平均与护理经理进行6.7次就诊。抑郁症护理管理的成本估计为每位参与者512美元。
在现有的糖尿病管理团队中增加一名抑郁症护理经理，能以合理的成本有效减轻抑郁症状。
