Research ers noted small improvements in body mass index immediately after the intervention was provided and at six months , along with improved weight post intervention .
Diabetes knowledge and self efficacy improved immediately following receipt of the intervention , and knowledge also at six months .
The intervention did not improve blood pressure .
Evidence is insufficient to show whether type 2 diabetes self management interventions for people with severe mental illness are effective in improving outcomes .
BACKGROUND People with severe mental illness are twice as likely to develop type 2 diabetes as those without severe mental illness .
Treatment guidelines for type 2 diabetes recommend that structured education should be integrated into routine care and should be offered to all .
However , for people with severe mental illness , physical health may be a low priority , and motivation to change may be limited .
These additional challenges mean that the findings reported in previous systematic review s of diabetes self management interventions may not be generalised to those with severe mental illness , and that tailored approaches to effective diabetes education may be required for this population .
OBJECTIVES To assess the effects of diabetes self management interventions specifically tailored for people with type 2 diabetes and severe mental illness .
The Pathways Study: a randomized trial of collaborative care in patients with diabetes and depression.
BACKGROUND There is a high prevalence of depression in patients with diabetes mellitus . Depression has been shown to be associated with poor self-management ( adherence to diet , exercise , checking blood glucose levels ) and high hemoglobin A1c ( HbA1c ) levels in patients with diabetes . OBJECTIVE To determine whether enhancing quality of care for depression improves both depression and diabetes outcomes in patients with depression and diabetes . DESIGN R and omized controlled trial with recruitment from March 1 , 2001 , to May 31 , 2002 . SETTING Nine primary care clinics from a large health maintenance organization . PARTICIPANTS A total of 329 patients with diabetes mellitus and comorbid major depression and /or dysthymia . Intervention Patients were r and omly assigned to the Pathways case management intervention ( n = 164 ) or usual care ( n = 165 ) . The intervention provided enhanced education and support of antidepressant medication treatment prescribed by the primary care physician or problem-solving therapy delivered in primary care . MAIN OUTCOME MEASURES Independent blinded assessment s at baseline and 3 , 6 , and 12 months of depression ( Hopkins Symptom Checklist 90 ) , global improvement , and satisfaction with care . Automated clinical data were used to evaluate adherence to antidepressant regimens , percentage receiving specialty mental health visits , and HbA1c levels . RESULTS When compared with usual care patients , intervention patients showed greater improvement in adequacy of dosage of antidepressant medication treatment in the first 6-month period ( odds ratio [ OR ] , 4.15 ; 95 % confidence interval [ CI ] , 2.28 - 7.55 ) and the second 6-month period ( OR , 2.90 ; 95 % CI , 1.69 - 4.98 ) , less depression severity over time ( z = 2.84 , P = .004 ) , a higher rating of patient-rated global improvement at 6 months ( intervention 69.4 % vs usual care 39.3 % ; OR , 3.50 ; 95 % CI , 2.16 - 5.68 ) and 12 months ( intervention 71.9 % vs usual care 42.3 % ; OR , 3.50 ; 95 % CI , 2.14 - 5.72 ) , and higher satisfaction with care at 6 months ( OR , 2.01 ; 95 % CI , 1.18 - 3.43 ) and 12 months ( OR , 2.88 ; 95 % CI , 1.67 - 4.97 ) . Although depressive outcomes were improved , no differences in HbA1c outcomes were observed . CONCLUSION The Pathways collaborative care model improved depression care and outcomes in patients with comorbid major depression and /or dysthymia and diabetes mellitus , but improved depression care alone did not result in improved glycemic control
Research ers noted small improvements in body mass index immediately after the intervention was provided and at six months , along with improved weight post intervention .
Diabetes knowledge and self efficacy improved immediately following receipt of the intervention , and knowledge also at six months .
The intervention did not improve blood pressure .
Evidence is insufficient to show whether type 2 diabetes self management interventions for people with severe mental illness are effective in improving outcomes .
BACKGROUND People with severe mental illness are twice as likely to develop type 2 diabetes as those without severe mental illness .
Treatment guidelines for type 2 diabetes recommend that structured education should be integrated into routine care and should be offered to all .
However , for people with severe mental illness , physical health may be a low priority , and motivation to change may be limited .
These additional challenges mean that the findings reported in previous systematic review s of diabetes self management interventions may not be generalised to those with severe mental illness , and that tailored approaches to effective diabetes education may be required for this population .
OBJECTIVES To assess the effects of diabetes self management interventions specifically tailored for people with type 2 diabetes and severe mental illness .