Please select the arm or intervention descriptions that belong to the clinical trial below.
Title: TeamCare PCN: Collaborative Care for Patients With Diabetes and Depression in Primary Care Networks
Brief Summary: Background \& Objective: Type 2 diabetes is a complex disease characterized by multiple comorbidities. Depression is one of the most common comorbidities in individuals with diabetes with prevalence rates reaching 30%. Depression complicates diabetes treatment, portends worse outcomes and increases health care costs. One novel approach to managing diabetes with co-morbid depression is a collaborative primary care model involving a multidisciplinary health care team guiding patient-centered care. This model has been tested in the US and showed a significant reduction of depressive symptoms, improved diabetes care and patient-reported outcomes, and saved money. Our aim is to evaluate the implementation of this collaborative care model for type 2 diabetes and comorbid depression within the non-metro Primary Care Network (PCN) setting in Canada.

Intervention: The intervention involves three phases: (1) improving depressive symptoms, (2) improving blood sugar, blood pressure and cholesterol, and (3) improving lifestyle behaviours. The intervention is administered by a CM in collaboration with family physicians, psychiatrists, and internists.

Hypotheses: The TeamCare-PCN intervention will reduce depressive symptoms, achieve targets for cardio-metabolic measures and improve lifestyle behaviours. Furthermore, the investigators anticipate this intervention will be acceptable and implemented in a cost-effective manner in the PCN environment.

Methods: The investigators will employ a mixed-methods approach to our evaluation, using a controlled "on-off" trial design. Our primary analysis will be based on a multivariable scaled marginal model for the combined outcome of depressive symptoms and medical care. Secondary analyses will assess changes in lifestyle behaviours and patient-reported outcomes.

Significance: Our work will serve as a platform upon which an emerging model of primary care can incorporate an effective and cost-effective depression intervention into the management of individuals with type 2 diabetes, and as a framework for implementing and evaluating similar interventions in individuals with other chronic conditions.


Options:
A: Arm Label: Electronic (USB) Portable Health File; Type: EXPERIMENTAL; Interventions: Device: Electronic (USB) Portable Health File | Arm Label: Paper Portable Health File; Type: EXPERIMENTAL; Interventions: Device: Paper Portable Health File | Arm Label: Usual standard of care; Type: NO_INTERVENTION; Interventions: N/A | Intervention Type: DEVICE; Name: Electronic (USB) Portable Health File; Assigned to Arm(s): Electronic (USB) Portable Health File | Intervention Type: DEVICE; Name: Paper Portable Health File; Assigned to Arm(s): Paper Portable Health File
B: Arm Label: Health Coaching; Type: EXPERIMENTAL; Interventions: Behavioral: Health coaching by medical assistants in primary care | Intervention Type: BEHAVIORAL; Name: Health coaching by medical assistants in primary care; Assigned to Arm(s): Health Coaching
C: Arm Label: Auto DAS; Type: EXPERIMENTAL; Interventions: Behavioral: Auto-DAS | Arm Label: Comorbidities treatment; Type: ACTIVE_COMPARATOR; Interventions: Behavioral: Comorbidities treatment | Intervention Type: BEHAVIORAL; Name: Comorbidities treatment; Assigned to Arm(s): Comorbidities treatment | Intervention Type: BEHAVIORAL; Name: Auto-DAS; Assigned to Arm(s): Auto DAS
D: Arm Label: Usual Care; Type: ACTIVE_COMPARATOR; Interventions: Other: Usual diabetes and depression care | Arm Label: TeamCare Depression Intervention; Type: EXPERIMENTAL; Interventions: Other: TeamCare Depression Intervention | Intervention Type: OTHER; Name: TeamCare Depression Intervention; Assigned to Arm(s): TeamCare Depression Intervention | Intervention Type: OTHER; Name: Usual diabetes and depression care; Assigned to Arm(s): Usual Care

Answer: D