Jeffrey Johnson|Fatima Al Sayah|Lisa Wozniak|Sandra Rees|Allison Soprovich|Constance L. Chik|Pierre Chue|Peter Florence|Jennifer Jacquier|Pauline Lysak|Andrea Opgenorth|Wayne Katon|Sumit R. Majumdar
Controlled trial of a collaborative primary care team model for patients with diabetes and depression: Rationale and design for a comprehensive evaluation
Alliance for Canadian Health Outcomes Research in Diabetes|University of Alberta|Alliance for Canadian Health Outcomes Research in Diabetes|University of Alberta|Alliance for Canadian Health Outcomes Research in Diabetes|University of Alberta|Alliance for Canadian Health Outcomes Research in Diabetes|University of Alberta|Alliance for Canadian Health Outcomes Research in Diabetes|University of Alberta|University of Alberta|Alberta Health Services|University of Alberta|Alberta Health Services|University of Alberta|University of Alberta|University of Alberta|University of Washington|Seattle University|Alliance for Canadian Health Outcomes Research in Diabetes|University of Alberta
depression accompanies diabetes complicates treatment portends worse outcomes increases health care costs collaborative care casemanagement model previously tested urban managed care organization us achieved significant reduction depressive symptoms improved diabetes disease control patientreported outcomes saved money impressive findings need replicated extended healthcare settings objective comprehensively evaluate collaborative care model comorbid depression type 2 diabetes within canadian primary care settingwe initiated teamcare model four primary care networks northern alberta intervention involves nurse care manager guiding patientcentered care family physicians consultant physician specialists monitor progress develop tailored care plans patients eligible intervention identified using patient health questionnaire9 screen depressive symptoms care managers guide patients three phases 1 improving depressive symptoms 2 improving blood glucose blood pressure cholesterol 3 improving lifestyle behaviors employ reaim framework comprehensive mixedmethods approach evaluation effectiveness assessed using controlled onoff trial design whereby eligible patients would alternately enrolled teamcare intervention usual care monthly basis patients assessed baseline 6 12 months primary analyses based changes two outcomes depressive symptoms multivariable scaled marginal model combined outcome global disease control ie a1c systolic blood pressure ldl cholesterol planned enrolment 168 patients provide greater 80 power observe clinically important improvements measured outcomes direct costing intervention components measurement health care utilization using linked administrative databases used determine costeffectiveness intervention relative usual careour comprehensive evaluation generate evidence reliability effectiveness sustainability collaborative care model patients chronic diseases depressionclinicaltrialsgov identifier nct01328639