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- Title
A collaborative care program for management of common mental disorders among diabetic patients in a primary healthcare setting.
- Authors
Moinfar, Zeinab; Sedaghat, Mojtaba; Abolhassani, Farid; Sharifi, Vandad; Moinfar, Zahra; Eftekhari, Sahar; Mirzaaghaee, Farzaneh
- Abstract
Aims: Type 2 diabetes mellitus (T2DM) is a chronic condition with high and increasing prevalence. Psychiatric disorders are very common among these patients. We aimed to assess the effect of a collaborative care program for management of common mental disorders among T2DM patients on their metabolic outcomes. Subjects and methods: In this before-after study, a group of T2DM patients was enrolled from nine chronic care centers of a primary healthcare service. A trained team managed both the psychiatric and metabolic conditions according to evidence-based guidelines. The primary care team was in collaborative contact with a specialized service at a Community Mental Health Center. Patients' glycemic measures, lipid profile, and weight were measured 3 months after the psychiatric intervention. Results: Among 2757 diabetic patients visited, 536 (19.44 %) were diagnosed as having a common mental disorder. Mean age of included patients (435) was 56.5 ± 9.74. Major depressive disorder and generalized anxiety disorder were the most common mental disorders with a frequency of 219 (50.3 %) and 197 (46.7 %), respectively. There was no statistically significant improvement in glycemic and metabolic control after the psychiatric intervention; however, control of blood pressure was improved. Moreover, significant improvements were observed in average glycosylated hemoglobin (HbA1c) (p < 0.001) and fasting plasma glucose (FPG) (p < 0.01) in patients with previously poor glycemic control. Conclusion: Although management of psychiatric conditions in a collaborative care program yielded no significant effect on metabolic outcomes and glycemic control in the total sample, patients with poor glycemic control experienced significant improvement in FPG and HbA levels.
- Subjects
IRAN; BENZODIAZEPINES; TRANQUILIZING drugs; SEROTONIN uptake inhibitors; ACADEMIC medical centers; BLOOD sugar; CHOLESTEROL; MENTAL depression; PEOPLE with diabetes; FASTING; GLYCOSYLATED hemoglobin; HIGH density lipoproteins; INTERPROFESSIONAL relations; LOW density lipoproteins; MENTAL health services; NEUROSES; TYPE 2 diabetes; HEALTH outcome assessment; PAIRED comparisons (Mathematics); PRIMARY health care; PROBABILITY theory; QUESTIONNAIRES; STATISTICS; T-test (Statistics); TRIGLYCERIDES; DATA analysis; BODY mass index; DATA analysis software; GENERALIZED anxiety disorder; DESCRIPTIVE statistics; MANN Whitney U Test
- Publication
Journal of Public Health (09431853), 2016, Vol 24, Issue 4, p273
- ISSN
0943-1853
- Publication type
Article
- DOI
10.1007/s10389-016-0722-y