scholarly journals Comparative Effectiveness of a Technology-Facilitated Depression Care Management Model in Safety-Net Primary Care Patients With Type 2 Diabetes: 6-Month Outcomes of a Large Clinical Trial

2018 ◽  
Vol 20 (4) ◽  
pp. e147 ◽  
Author(s):  
Shinyi Wu ◽  
Kathleen Ell ◽  
Haomiao Jin ◽  
Irene Vidyanti ◽  
Chih-Ping Chou ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Comparative Effectiveness ◽  
Care Management ◽  
Safety Net ◽  
Management Model ◽  
Depression Care ◽  
Large Clinical Trial ◽  
Depression Care Management ◽  
Primary Care Patients

scholarly journals Cost-Effectiveness of a Technology-Facilitated Depression Care Management Adoption Model in Safety-Net Primary Care Patients with Type 2 Diabetes

2018 ◽  
Vol 21 (5) ◽  
pp. 561-568 ◽  
Author(s):  
Joel W. Hay ◽  
Pey-Jiuan Lee ◽  
Haomiao Jin ◽  
Jeffrey J. Guterman ◽  
Sandra Gross-Schulman ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Primary Care ◽  
Cost Effectiveness ◽  
Care Management ◽  
Safety Net ◽  
Depression Care ◽  
Depression Care Management ◽  
Primary Care Patients ◽  
Adoption Model

scholarly journals Preliminary outcomes of the development of an Active Ageing with Type 2 Diabetes Chronic Care Management Model in Europe

2015 ◽  
Vol 15 (5) ◽  
Author(s):  
George E. Dafoulas ◽  
Caroline Lang ◽  
Johan Wens ◽  
Konstantinos Makrilakis ◽  
Stavros Liatis ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Care Management ◽  
Chronic Care ◽  
Management Model ◽  
Active Ageing ◽  
Chronic Care Management

scholarly journals Comparative Effectiveness of a Technology-Facilitated Depression Care Management Model in Safety-Net Primary Care Patients With Type 2 Diabetes: 6-Month Outcomes of a Large Clinical Trial (Preprint)

2017 ◽  
Author(s):  
Shinyi Wu ◽  
Kathleen Ell ◽  
Haomiao Jin ◽  
Irene Vidyanti ◽  
Chih-Ping Chou ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Primary Care ◽  
Usual Care ◽  
Diabetes Care ◽  
Functional Disability ◽  
Safety Net ◽  
P Value ◽  
Depression Care ◽  
Care Model

BACKGROUND Comorbid depression is a significant challenge for safety-net primary care systems. Team-based collaborative depression care is effective, but complex system factors in safety-net organizations impede adoption and result in persistent disparities in outcomes. Diabetes-Depression Care-management Adoption Trial (DCAT) evaluated whether depression care could be significantly improved by harnessing information and communication technologies to automate routine screening and monitoring of patient symptoms and treatment adherence and allow timely communication with providers. OBJECTIVE The aim of this study was to compare 6-month outcomes of a technology-facilitated care model with a usual care model and a supported care model that involved team-based collaborative depression care for safety-net primary care adult patients with type 2 diabetes. METHODS DCAT is a translational study in collaboration with Los Angeles County Department of Health Services, the second largest safety-net care system in the United States. A comparative effectiveness study with quasi-experimental design was conducted in three groups of adult patients with type 2 diabetes to compare three delivery models: usual care, supported care, and technology-facilitated care. Six-month outcomes included depression and diabetes care measures and patient-reported outcomes. Comparative treatment effects were estimated by linear or logistic regression models that used generalized propensity scores to adjust for sampling bias inherent in the nonrandomized design. RESULTS DCAT enrolled 1406 patients (484 in usual care, 480 in supported care, and 442 in technology-facilitated care), most of whom were Hispanic or Latino and female. Compared with usual care, both the supported care and technology-facilitated care groups were associated with significant reduction in depressive symptoms measured by scores on the 9-item Patient Health Questionnaire (least squares estimate, LSE: usual care=6.35, supported care=5.05, technology-facilitated care=5.16; P value: supported care vs usual care=.02, technology-facilitated care vs usual care=.02); decreased prevalence of major depression (odds ratio, OR: supported care vs usual care=0.45, technology-facilitated care vs usual care=0.33; P value: supported care vs usual care=.02, technology-facilitated care vs usual care=.007); and reduced functional disability as measured by Sheehan Disability Scale scores (LSE: usual care=3.21, supported care=2.61, technology-facilitated care=2.59; P value: supported care vs usual care=.04, technology-facilitated care vs usual care=.03). Technology-facilitated care was significantly associated with depression remission (technology-facilitated care vs usual care: OR=2.98, P=.04); increased satisfaction with care for emotional problems among depressed patients (LSE: usual care=3.20, technology-facilitated care=3.70; P=.05); reduced total cholesterol level (LSE: usual care=176.40, technology-facilitated care=160.46; P=.01); improved satisfaction with diabetes care (LSE: usual care=4.01, technology-facilitated care=4.20; P=.05); and increased odds of taking an glycated hemoglobin test (technology-facilitated care vs usual care: OR=3.40, P<.001). CONCLUSIONS Both the technology-facilitated care and supported care delivery models showed potential to improve 6-month depression and functional disability outcomes. The technology-facilitated care model has a greater likelihood to improve depression remission, patient satisfaction, and diabetes care quality.

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