PHILADELPHIA – Researchers at the University of Pennsylvania School of Medicine report that older adults with diabetes and depression are half as likely to die over a 5-year period when they receive depression care management than depressed patients with diabetes who do not receive depression care management. The first known study to examine the relationship between diabetes and mortality in a depression intervention trial appears in the December issue of Diabetes Care.
“Depression is common among people with diabetes and contributes to issues with medication and diet adherence, and also leads to an overall reduced quality of life,” says lead author, Hillary R. Bogner, MD, MSCE, Assistant Professor, Department of Family Practice and Community Medicine at Penn.
The multi-site, practice-randomized controlled trial was conducted in 20 primary care practices in New York City, Philadelphia, and Pittsburgh. A total of 584 participants 60 – 94 years of age were identified through a depression screening, and of these participants, 123 reported a history of diabetes. The practices were randomly assigned to usual care, or a depression care management intervention, which involved a depression care manager who worked with the primary care provider to recommend treatment for depression and assist patients with treatment adherence.
At follow-up, 110 depressed patients had died. Depressed, older adults with diabetes who were in practices randomized to depression care management were less likely to have died at the end of the 5-year follow-up than were depressed, older adults with diabetes who received usual care. The authors note that they believe these findings support the integration of depression evaluation and treatment with diabetes management in primary care.
Additional study authors include Knashawn H. Morales, ScD, Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania School of Medicine; Edward P. Post, MD, PhD, VA Health Services Research and Development & National Serious Mental Illness Treatment Research and Evaluation Center, Ann Arbor, MI, Department of Internal Medicine, University of Michigan; and Martha L. Bruce, PhD, MPH, Department of Psychiatry, Weill Medical College of Cornell University, White Plains, NY.
This study was funded by the National Institute of Mental Health.
PENN Medicine is a $3.5 billion enterprise dedicated to the related missions of medical education, biomedical research, and excellence in patient care. PENN Medicine consists of the University of Pennsylvania School of Medicine (founded in 1765 as the nation's first medical school) and the University of Pennsylvania Health System.
Penn's School of Medicine is currently ranked #3 in the nation in U.S.News & World Report's survey of top research-oriented medical schools; and, according to most recent data from the National Institutes of Health, received over $379 million in NIH research funds in the 2006 fiscal year. Supporting 1,400 fulltime faculty and 700 students, the School of Medicine is recognized worldwide for its superior education and training of the next generation of physician-scientists and leaders of academic medicine.
The University of Pennsylvania Health System includes three hospitals — its flagship hospital, the Hospital of the University of Pennsylvania, rated one of the nation’s “Honor Roll” hospitals by U.S.News & World Report; Pennsylvania Hospital, the nation's first hospital; and Penn Presbyterian Medical Center — a faculty practice plan; a primary-care provider network; two multispecialty satellite facilities; and home care and hospice.
Journal
Diabetes Care