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The Effectiveness of Depression Care Management on Diabetes-Related Outcomes in Older Patients

John W. Williams Jr., MD, MHSc; Wayne Katon, MD; Elizabeth H.B. Lin, MD; Polly H. Nöel, PhD; Jason Worchel, MD; John Cornell, PhD; Linda Harpole, MD, MPH; Bridget A. Fultz, MA; Enid Hunkeler, MA; Virginia S. Mika, MPH; Jürgen Unützer, MD, the IMPACT Investigators*
[+] Article, Author, and Disclosure Information

From Center for Health Services Research in Primary Care, Durham Veterans Affairs Medical Center, and Duke University School of Medicine, Durham, North Carolina; University of Washington School of Medicine and Group Health Cooperative of Puget Sound, Seattle, Washington; South Texas Veterans Health Care System and University of Texas Health Science Center, San Antonio, Texas; Central Texas Veterans Health Care System, Austin, Texas; Indiana University Center for Aging Research, Regenstrief Institute, Inc., Indianapolis, Indiana; Kaiser Permanente of Northern California, Oakland, California; and University of California, Los Angeles, Los Angeles, California.

Disclaimer: The views expressed in this article are those of the authors and do not necessarily represent the views of the Department of Veterans Affairs.

Acknowledgments: The authors thank the contributions of the IMPACT study advisory board (Lydia Lewis; Lisa Goodale, ACSW; Howard Goldman, MD, PhD; Thomas Oxman, MD; Lisa Rubenstein, MD, MSPH; Cathy Sherbourne, PhD; Kenneth Wells, MD, MPH); statistical consultation from Lingqi Tang, PhD; and outstanding programming support by Tonya Marmon, MS. The authors also acknowledge the contributions and support of patients, providers, and staff and the use of resources and facilities at the study coordinating center and at all participating study sites.

Grant Support: By grants from the Robert Wood Johnson Foundation, the John A. Hartford Foundation, the California Healthcare Foundation, and the Hogg Foundation.

Potential Financial Conflicts of Interest:Consultancies: J.W. Williams Jr. (GlaxoSmithKline, Pfizer), E.H.B. Lin (Pfizer, Wyeth); Honoraria: J.S. Williams Jr. (Pfizer, Wyeth-Ayerst), E.H.B. Lin (Pfizer, Wyeth); Grants received: J.W. Williams Jr. (Eli Lilly, Pfizer), E.M. Hunkeler (Eli Lilly, Merck & Co., Solvay).

Requests for Single Reprints: John W. Williams, MD, MHSc, Durham Veterans Affairs Medical Center (152), Center for Health Services Research in Primary Care, 508 Fulton Street, Durham, NC 27705.

Current Author Addresses: Dr. Williams: Center for Health Services Research in Primary Care, HSR&D (Building 6), 508 Fulton Street, Durham, NC 27705.

Drs. Katon and Unützer: Department of Psychiatry, University of Washington, Box 356560, 1959 NE Pacific, Seattle, WA 98195.

Dr. Lin: Center for Health Studies, Group Health Cooperative, 1730 Minor Avenue #1600, Seattle, WA 98101.

Drs. Nöel and Cornell: South Texas Veterans Health Care System, 7400 Merton Minter Boulevard, San Antonio, TX 78229.

Dr. Worchel: Central Texas Veterans Health Care System, 2901 Montopolis, Austin, TX 78741.

Dr. Harpole: Duke University Medical Center, 3024 Pickett Road, Durham, NC 27705.

Ms. Fultz: Regenstrief Institute, Inc., 1050 Wishard Boulevard, RG 6, Indianapolis, IN 46202.

Ms. Hunkeler: Division of Research, Kaiser Permanente–Northern California, 3505 Broadway, 7th Floor, Oakland, CA 94611.

Ms. Mika: University of Texas Health Science Center, 7703 Floyd Curl Drive, San Antonio, TX 78229.

Ann Intern Med. 2004;140(12):1015-1024. doi:10.7326/0003-4819-140-12-200406150-00012
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The Improving Mood–Promoting Access to Collaborative Treatment (IMPACT) study is a multisite randomized, controlled trial of a collaborative care intervention program for late-life depression in primary care (3738). Institutional review boards at participating sites approved study protocols, and all participants gave written informed consent.

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Flowchart of participants in the trial.

*Because funding for hemoglobin A1c (HbA1c1c) values was obtained after the trial had begun, some patients were not approached for these values. Neither baseline nor follow-up hemoglobin A values were imputed for analysis. †The analysis includes all participants, except those excluded because of death, after multiple imputation of unit-level missing data.

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Summary for Patients

Depression Care Management for Older Adults with both Depression and Diabetes

The summary below is from the full report titled “The Effectiveness of Depression Care Management on Diabetes-Related Outcomes in Older Patients.” It is in the 15 June 2004 issue of Annals of Internal Medicine (volume 140, pages 1015-1024). The authors are J.W. Williams Jr., W. Katon, E.H.B. Lin, P.H. Nöel, J. Worchel, J. Cornell, L. Harpole, B.A. Fultz, E. Hunkeler, V.S. Mika, and J. Unützer.


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