Diabetes and Depression Care: A Randomized Controlled Pilot Trial

Objective: We examined the comparative effectiveness of an integrated intervention for Type 2 diabetes mellitus (T2DM) and depression by employing patient prioritized planning (PPP) to incorporate patients' financial, social, and emotional needs versus an integrated intervention alone. Methods: A randomized controlled pilot trial randomly assigned 78 patients prescribed pharmacotherapy for T2DM in primary care to an integrated intervention for T2DM and depression employing PPP to incorporate patients' financial, social, and emotional needs (enhanced intervention) versus an integrated intervention alone (basic intervention). Hemoglobin A1C (HbA1C) assays measured glycemic control and the Center for Epidemiologic Studies Depression Scale (CES-D) assessed depression. Results: Patients in the enhanced intervention had a significantly greater mean change in HbA1C from baseline in comparison with the basic intervention at 12 weeks (enhanced intervention -0.63 vs basic intervention 0.15; p=.027). Patients in the enhanced intervention also had a significantly greater mean change in CES-D from baseline in comparison with patients in the basic intervention group at 12 weeks (enhanced intervention -3.75 vs basic intervention 0.93; p=.041). Conclusions: Our pilot trial results indicate that an integrated care intervention employing PPP to incorporate financial, social and emotional needs for primary care patients with T2DM and depression may be effective.