Improving Treatment of Depression Among Latinos With Diabetes Using Project Dulce and IMPACT
- Todd P. Gilmer, PHD1,
- Chris Walker, MPH2,
- Elizabeth D. Johnson, MSW2,
- Athena Philis-Tsimikas, MD2 and
- Jürgen Unützer, MD3
- 1Department of Family and Preventive Medicine, University of California, San Diego, La Jolla, California
- 2Whittier Institute for Diabetes, La Jolla, California
- 3Department of Psychiatry, University of Washington School of Medicine, Seattle, Washington
- Corresponding author: Todd P. Gilmer, tgilmer{at}ucsd.edu
Abstract
OBJECTIVE—To assess the feasibility and cost of integrating diabetes and depression care management in three community clinics serving a low-income and predominately Spanish-speaking Latino population.
RESEARCH DESIGN AND METHODS—We screened diabetes patients for depression, and for those with depressive symptoms, we provided depression care management. We assessed changes in depressive symptoms using the Patient Health Questionnaire-9 (PHQ-9), diabetes self-care activities (nutrition, exercise, and medication adherence), and costs.
RESULTS—Thirty-three percent of patients with diabetes had symptoms of major depression. Among 99 patients completing the study, PHQ-9 scores declined by an average of 7.5 points from 14.8 to 7.3 (P < 0.001). Clients averaged 6.7 visits with the care manager during the study period. Costs of depression care management were estimated to be $512 per participant.
CONCLUSIONS—Adding a depression care manager to an existing diabetes management team was effective at reducing depressive symptoms at a reasonable cost.
Footnotes
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Published ahead of print at http://care.diabetesjournals.org on 20 March 2008.
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- Accepted March 18, 2008.
- Received February 11, 2008.
- DIABETES CARE
