Integrating depression and chronic disease care among patients with diabetes and/or coronary heart disease: the design of the TEAMcare study
Open accessAbstract
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.
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The TeamCare trial evaluated a collaborative integrated care model for patients with diabetes and/or heart disease and depression in community-based primary care clinics in Washington State and demonstrated improved physical and mental health outcomes compared to care as usual.
“such as the TeamCare trial which evaluated a collaborative integrated care model for patients with diabetes and/or heart disease and depression in community-based primary care clinics in Washington State and demonstrated improved physical and mental health outcomes when compared to care as usual 30-32 33”
From Integrated care for people with long-term mental and physical health conditions in low-income and middle-income countries (2019) · cites this paper as [32]
The majority of studies concerned with mental-physical comorbidity have addressed people with common mental disorders rather than severe mental illnesses.
“The majority of the studies concerned with mental-physical comorbidity have addressed people with common mental disorders (rather than severe mental illnesses)”
From Integrated care for people with long-term mental and physical health conditions in low-income and middle-income countries (2019) · cites this paper as [32]
Within LMICs, the key elements of the collaborative care model for people with common mental disorders are case screening, providing psychosocial treatments and adherence management; access to essential medicines; support of visiting psychiatrists, and active patient follow up.
“Within LMICs several studies have aimed to identify the active ingredients of the collaborative care model and, to date, the key elements for people with common mental disorders are: case screening, providing psychosocial treatments and adherence management; access to essential medicines; support of visiting psychiatrists, and active patient follow up 43 32 .”
From Integrated care for people with long-term mental and physical health conditions in low-income and middle-income countries (2019) · cites this paper as [32]
Newer intervention approaches integrate psychological treatments with exercise training, nurse-led self-management support, and nurse-, dietitian-, and mental health-specialist-delivered self-management interventions.
“These include interventions that integrate psychological treatments with exercise training (20), nurse-led self-management support (21), and nurse-, dietitian-, and mental health-specialist–delivered self-management interventions (22).”
From Depression in diabetes: have we been missing something important? (2011) · cites this paper as [20]
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- Authors
- Katon, W., Lin, E. H. B., Von Korff, M., Ciechanowski, P., Ludman, E., Young, B., Rutter, C., Oliver, M., & McGregor, M.
- Affiliations
- University of Washington (US)
- Kaiser Permanente Washington Health Research Institute (US)
- Corresponding author
- Katon, Wayne
- Venue
- Contemporary Clinical Trials
- Publisher
- Elsevier BV
- Published
- 2010-07
- Volume
- 31
- Issue
- 4
- Pages
- 312-322
- ISSN
- 1551-7144 (ISSN-L)
- PMC
- PMC3726010
- OpenAlex
- W2084447516
- Cited by
- 100
- References
- 60
- Citations by year
- 2026: 2 · 2025: 1 · 2023: 5 · 2022: 5 · 2021: 5 · 2020: 9 · 2019: 1 · 2018: 7 · 2017: 10 · 2016: 10 · 2015: 4 · 2014: 8 · 2013: 5 · 2012: 11
- FWCI
- 7.96
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Contemporary Clinical Trials (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute of Mental Health (R01MH041739, K08MH069741, K-24 MH069741, K24MH069471, MH4-1739)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Education
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Health and Mental Health
- Health Sciences › Medicine › Epidemiology › Chronic Disease Management Strategies
- Keywords
- comorbid depression, diabetes mellitus, coronary artery disease, biopsychosocial intervention, integrated care, team-based care, disease control, self-care, primary care, psychiatric nursing, integrated health plans, randomized controlled trial design
- MeSH terms
- Aged, Coronary Disease, Delivery of Health Care, Depression, Diabetes Mellitus, Female, Humans, Male, Middle Aged, Patient Care Planning, Patient Care Team, Research Design, Washington, Comorbidity
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