de Vries McClintock Heather F, Boyle Kathleen B, Rooney Kathryn, Bogner Hillary R
Department of Family Medicine and Community Health, University of Pennsylvania, Philadelphia, PA, USA.
Am J Health Behav. 2016 Jul;40(4):503-13. doi: 10.5993/AJHB.40.4.12.
We examined the comparative effectiveness of an integrated intervention for Type 2 diabetes mellitus (T2DM) and depression by employing patient prioritized planning (PPP) to incorporate patients' financial, social, and emotional needs versus an integrated intervention alone.
A randomized controlled pilot trial randomly assigned 78 patients prescribed pharmacotherapy for T2DM in primary care to an integrated intervention for T2DM and depression employing PPP to incorporate patients' financial, social, and emotional needs (enhanced intervention) versus an integrated intervention alone (basic intervention). Hemoglobin A1C (HbA1C) assays measured glycemic control and the Center for Epidemiologic Studies Depression Scale (CES-D) assessed depression.
Patients in the enhanced intervention had a significantly greater mean change in HbA1C from baseline in comparison with the basic intervention at 12 weeks (enhanced intervention -0.63 vs basic intervention 0.15; p = .027). Patients in the enhanced intervention also had a significantly greater mean change in CES-D from baseline in comparison with patients in the basic intervention group at 12 weeks (enhanced intervention -3.75 vs basic intervention 0.93; p = .041).
Our pilot trial results indicate that an integrated care intervention employing PPP to incorporate financial, social and emotional needs for primary care patients with T2DM and depression may be effective.
我们通过采用患者优先规划（PPP）纳入患者的财务、社会和情感需求，与单纯的综合干预措施相比，研究了2型糖尿病（T2DM）与抑郁症综合干预措施的相对有效性。
一项随机对照试验将78名在初级保健中接受T2DM药物治疗的患者随机分为两组，一组采用PPP纳入患者的财务、社会和情感需求，对T2DM和抑郁症进行综合干预（强化干预），另一组为单纯的综合干预（基础干预）。糖化血红蛋白（HbA1C）检测用于测量血糖控制情况，流行病学研究中心抑郁量表（CES-D）用于评估抑郁状况。
与基础干预组相比，强化干预组患者在12周时HbA1C从基线的平均变化显著更大（强化干预组为-0.63，基础干预组为0.15；p = 0.027）。与基础干预组患者相比，强化干预组患者在12周时CES-D从基线的平均变化也显著更大（强化干预组为-3.75，基础干预组为0.93；p = 0.041）。
我们的试验结果表明，采用PPP纳入财务、社会和情感需求的综合护理干预措施，对患有T2DM和抑郁症的初级保健患者可能是有效的。
