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Collaborative care can improve the health of adults who suffer from both depression and diabetes

Atlantis E, Fahey P, Foster J Collaborative care for comorbid depression and diabetes: A systematic review and meta-analysis BMJ Open. 2014; 4 (e004706).

Review question

Is collaborative care effective for improving the health of adults who suffer from both depression and diabetes?

Background

Depression and diabetes are ranked as the 11^th and 14^th leading causes of disease around the world respectively.

Adults suffering from both diseases face additional challenges, including worsening self-care, health status and economic situation, which can result in the need for more intensive forms of care. 

Collaborative care, which includes coordinated services delivered by a multi-disciplinary care team, has been shown as a promising approach for improving the health of adults who have depression or diabetes. However, there is uncertainty about the effectiveness of collaborative care for those who suffer from both diseases.

How the review was done

Several electronic databases were searched for literature published before August 2013. Studies were included if they evaluated collaborative care for adults who have depression and diabetes, and measured the effects on both depression and diabetes.

A total of 264 studies were identified. Seven of those were deemed eligible and included in the review.

The authors reported that no specific grant from any funding agency was used to support this work.

What the researchers found

Although based on limited evidence, collaborative care appears to significantly improve the symptoms of depression and glycemic control among adults who suffer from both depression and diabetes.

The level of improvement that can be expected from collaborative care is small to moderate. These improvements are comparable to other existing approaches to care, such as pharmacological, psychological, and behavioural approaches.

The evidence included in the review suggested that collaborative care improves the symptoms of depression and glycemic control independently. This means that improvements in depression did not lead to better glycemic control (and vice versa).  

Conclusion

The limited evidence included in this review suggests that collaborative care for adults who suffer from both depression and diabetes can improve outcomes related to depression and glycemic control.

Further studies will likely strengthen the relationships observed in this review.