首页|Effect of a collaborative care model on anxiety symptoms among patients with depression and diabetes in India: The INDEPENDENT randomized clinical trial

Effect of a collaborative care model on anxiety symptoms among patients with depression and diabetes in India: The INDEPENDENT randomized clinical trial

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  • NSTL
  • Elsevier
? 2021 Elsevier Inc.Objective: We assessed the impact of a collaborative care intervention on anxiety symptoms among participants in India with comorbid depression, poorly controlled diabetes, and moderate to severe anxiety symptoms. Method: We analyzed data from a randomized controlled trial conducted at four diabetes clinics in India. Participants received either collaborative care or usual care. We included only participants who scored ?10 on the Generalized Anxiety Disorder-7 (GAD-7) at baseline. We estimated the effect of the intervention on clinically significant reduction in anxiety symptoms; we considered several potential baseline moderators and mediation by anti-depressant use. Results: One hundred and seventy-two participants scored 10 or above on the GAD-7 at baseline. Collaborative care participants were more likely than control participants to achieve a clinically significant reduction in anxiety symptoms at 6 and 12 months (65.7% vs. 41.4% at 12 months, p = 0.002); these differences were not sustained at 18 or 24 months. There was little evidence of moderation by participant characteristics at baseline, and effects were not mediated by anti-depressant use. Conclusions: Collaborative care for the treatment of depression and type 2 diabetes can lead to clinically significant reductions in anxiety symptoms among patients with anxiety. Effects were notable during the active intervention period but not over the year post-intervention.

AnxietyCollaborative careDepressionDiabetesIndiaIntegrated care

Kemp C.G.、Johnson L.C.M.、Sagar R.、Poongothai S.、Tandon N.、Anjana R.M.、Aravind S.、Sridhar G.R.、Patel S.A.、Emmert-Fees K.、Rao D.、Narayan K.M.V.、Mohan V.、Ali M.K.、Chwastiak L.A.

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Department of International Health Johns Hopkins Bloomberg School of Public Health

Department of Family and Preventive Medicine School of Medicine Emory University

Department of Psychiatry All India Institute of Medical Sciences

Department of Clinical Trials Madras Diabetes Research Foundation

Department of Endocrinology & Metabolism All India Institute of Medical Sciences

Department of Diabetology Madras Diabetes Research Foundation

Diabetes Care and Research Center Diacon Hospital

Endocrine and Diabetes Centre

Hubert Department of Global Health Rollins School of Public Health Emory University

Institute for Health Economics and Health Care Management

Department of Global Health University of Washington

Department of Psychiatry and Behavioral Sciences University of Washington

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2022

10.1016/j.genhosppsych.2021.11.003

General hospital psychiatry

General hospital psychiatry

SCI
ISSN：0163-8343
年,卷(期)：2022.74
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