Integrating depression and chronic disease care among patients with diabetes and/or coronary heart disease: The design of the TEAMcare study
Integrating depression and chronic disease care among patients with diabetes and/or coronary heart disease: The design of the TEAMcare study
复制标题
DOI：
10.1016/j.cct.2010.03.009
复制
发表时间：
2010-07-01
影响因子：
2.2
通讯作者：
McGregor, Mary
中科院分区：
文献类型：
--
作者：
Katon, Wayne;Lin, Elizabeth H. B.;McGregor, Mary
糖尿病和冠心病（CHD）是美国人口中最常见的两种医学疾病，其中20%的患者患有抑郁症。糖尿病和冠心病的管理指南与健康生活方式和疾病控制建议重叠。然而，大多数患有这些医学疾病的患者已被证明对血压，LDL胆固醇或血糖等关键风险因素控制不足。共病抑郁症已被证明会对糖尿病和冠心病的自我护理产生不利影响，并与并发症和死亡率的风险增加有关。改善糖尿病和冠心病患者抑郁症护理质量和结局的干预措施在自我护理，改善疾病控制或发病率和死亡率方面没有表现出益处。本文介绍了一种新的生物心理社会干预（TEAMcare）的设计和开发，旨在改善医疗疾病控制和抑郁症的糖尿病和/或冠心病控制不佳的患者符合共病抑郁症的标准。采用团队方法，由护士干预员每周接受精神科和初级保健医生的病例量监督，以加强初级保健医生的治疗。这种干预措施正在NIMH资助的一项大型综合健康计划的随机对照试验中进行测试。(C)2010年爱思唯尔公司All rights reserved.
Diabetes and coronary heart disease (CHD) are two of the most prevalent medical illnesses in the US population and comorbid depression occurs in up to 20% of these patients. Guidelines for management of diabetes and CHD overlap for healthy lifestyle and disease-control recommendations. However, the majority of patients with these medical illnesses have been shown to have inadequate control of key risk factors such as blood pressure, LDL cholesterol, or blood sugar. Comorbid depression has been shown to adversely affect self-care of diabetes and CHD, and is associated with an increased risk of complications and mortality. Interventions that have improved quality and outcomes of depression care alone in patients with diabetes and CHD have not demonstrated benefits in self-care, improved disease control or morbidity and mortality. This paper describes the design and development of a new biopsychosocial intervention (TEAMcare) aimed at improving both medical disease control and depression in patients with poor control of diabetes and/or CHD who met the criteria for comorbid depression. A team approach is used with a nurse interventionist who receives weekly psychiatric and primary care physician caseload supervision in order to enhance treatment by the primary care physician. This intervention is being tested in an NIMH-funded randomized controlled trial in a large integrated health plan. (C) 2010 Elsevier Inc. All rights reserved.