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January/February 2012 Annals of Family Medicine
Date:1/9/2012

ention group 1) increased self-monitoring of key disease parameters relative to usual care patients and 2) had higher pharmacotherapy adjustment rates relative to usual care patients. At 12 months, the average rate of blood pressure monitoring was more than three times higher in the intervention group compared with the usual care group (3.6 days vs. 1.1 days per week), and the average blood glucose monitoring rate was 4.9 days per week vs. 3.8 days per week, respectively. Pharmacotherapy initiation and adjustment rates were six times higher for antidepressants, three times higher for insulin and nearly two times higher for antihypertensive medications among patients in the intervention group relative to usual care. Researchers did not find any difference in medication adherence rates. High baseline rates, they hypothesize, may have exerted a ceiling effect on potential improvements in medication adherence. The authors conclude these findings support the use of collaborative, team-based care management programs that target self-monitoring and timely treatment adjustment for patients with complex care needs.

Treatment Adjustment and Medication Adherence for Complex Patients With Diabetes, Heart Disease and Depression: A Randomized Controlled Trial

By Elizabeth H. B. Lin, MD, MPH, et al

Group Health Cooperative, Seattle

Intervention Integrating Care for Type 2 Diabetes and Depression Improves Patient Outcomes

A simple, brief treatment intervention using integration care managers is successful in improving medication adherence and disease outcomes for patients with comorbid depression and type 2 diabetes, a group known to have poor treatment adherence. Key components of the intervention were the integration of depression treatment with type 2 diabetes management and the provision of an individualized program to improve adherence to antidepressants and oral hypoglycemic agents that recognized the patients' social and cultural context. Pri
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Contact: Angela Sharma
asharma@aafp.org
913-269-2269
American Academy of Family Physicians
Source:Eurekalert

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