Individuals treated for both depression and Type 2 diabetes have better medication compliance and experience significant improvements in depression and blood sugar levels compared to those receiving typical treatments, according to a new study out of the University of Pennsylvania.
Over 60 percent of patients who received both treatments along with a short period of intervention to encourage adherence to prescribed medication regimens experienced improved blood sugar levels and 58 percent had fewer depression symptoms, compared to only 36 percent and 31 percent, respectively, of patients who received regular care.
Depression is a known risk factor for diabetes, and diabetes also increases the risk for the development of depression. Depression is frequently found in patients with diabetes, and it tends to contribute to poor adherence to medication routines, which hinders diabetes management.
“Though research demonstrates the link between depression and diabetes, few integrated programs are being implemented in practice,” said lead author Hillary Bogner, MD, MSCE, an assistant professor in the Perelman School of Medicine at the University of Pennsylvania.
“Our results demonstrate that integrated treatment for both conditions, combined with a brief program focused on adherence for primary care patients with Type 2 diabetes and depression can result in a significant improvement in clinical outcomes.”
“We hope the findings will encourage the adoption of adherence programs aimed at improving outcomes.”
For the study, researchers randomly assigned volunteers to integrated care or usual care groups. Integrated treatment combined typical primary care with a brief medication adherence program.
Patients and primary care physicians worked with integrated care managers to identify and talk about possible potential medication regimen problems, such as the cost of medications, or a lack of social support.
Individualized programs were developed to improve adherence to antidepressants and diabetes medication. By attaching electronic monitors to pill bottles, researchers kept track of the precise date and time participants took their prescribed medications over the 12-week period.
In the end, 60.9 percent of subjects who received the integrated approach had improved blood sugar levels, compared to only 35.7 percent of patients who received only the usual primary care. Also, patients in the integrated care group were more likely to show fewer depression symptoms in comparison with patients in the usual care group (58.7 percent vs. 30.7 percent, respectively).
“Our study calls for a greater emphasis within healthcare systems on the development and promotion of clinical programs to enhance medication adherence, particularly among patients with chronic medical conditions and depression,” said Dr. Bogner.
“An integrated approach to depression and type 2 diabetes treatment may facilitate adoption in practices with competing demands for limited resources.”
The study is published in the January/February issue of The Annals of Family Medicine.
Source: University of Pennsylvania