Collaborative care for comorbid depression and diabetes: a systematic review and meta-analysis
Open accessAbstract
Objective: The collaborative care model is recommended for depression in adults with a chronic physical health problem like diabetes. We sought to systematically assess the effect of collaborative care on depression and glycaemia in adults with comorbid depression and diabetes to inform guidelines and practice. Design: Systematic review and meta-analysis. Data sources: We searched PubMed, Scopus, Cochrane Library, CINAHL, Health Source Nursing, MEDLINE, PsychINFO and reference lists of retrieved articles published before August 2013. Inclusion criteria: Randomised controlled trials (RCTs) on collaborative care (ie, coordinated multidisciplinary model of care) for depression that reported the effects on depression and glycaemic outcomes in adults with comorbid clinically relevant depression and diabetes were eligible. Data extraction and analysis: Data on the mean difference in depression and glycaemic outcomes were extracted and pooled using random effects meta-analysis. Results: Seven RCTs included for review reported effects on depression outcomes in 1895 participants, and glycated haemoglobin (HbA1c) level in 1556 participants. Collaborative care significantly improved the depression score (standardised mean difference was −0.32 (95% CI −0.53 to −0.11); I 2=79%) and HbA1c level (weighted mean difference was −0.33% (95% CI −0.66% to −0.00%); I 2=72.9%) compared with control conditions. Depression remission did not predict better glycaemic control across studies. Conclusions: Limited evidence from short-to-medium term RCTs predominantly conducted in the USA suggests that collaborative care for depression significantly improves both depression and glycaemia outcomes, independently, in people with comorbid depression and diabetes.
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Reductions in depression severity are not correlated with reductions in levels of HbA1c in collaborative care.
“However, the reductions in depression severity were not correlated with reductions in levels of HbA1c.”
From Type 2 diabetes mellitus and psychological stress — a modifiable risk factor (2017) · cites this paper as [142]
Collaborative care reduces depression scores and levels of HbA1c in people with diabetes mellitus.
“The results suggest that collaborative care reduces depression scores and levels of HbA1c in people with diabetes mellitus.”
From Type 2 diabetes mellitus and psychological stress — a modifiable risk factor (2017) · cites this paper as [142]
Reductions in the severity of depression following collaborative care are not statistically significantly associated with reductions in HbA1c.
“However, the reductions reported in the severity of depression following collaborative care were not statistically significantly associated with reductions in HbA1c.”
From Type 2 diabetes mellitus and psychological stress — a modifiable risk factor (2017) · cites this paper as [142]
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- Authors
- Atlantis, E., Fahey, P., & Foster, J.
- Affiliations
- The University of Adelaide (AU)
- Western Sydney University (AU)
- Corresponding author
- Atlantis, Evan
- Venue
- BMJ Open
- Publisher
- BMJ
- Published
- 2014-04
- Volume
- 4
- Issue
- 4
- Pages
- e004706
- ISSN
- 2044-6055 (ISSN-L)
- PMC
- PMC3987739
- OpenAlex
- W2064974721
- Cited by
- 179
- References
- 11
- Citations by year
- 2026: 3 · 2025: 10 · 2024: 14 · 2023: 18 · 2022: 17 · 2021: 19 · 2020: 21 · 2019: 12 · 2018: 16 · 2017: 16 · 2016: 21 · 2015: 10 · 2014: 2
- FWCI
- 2.59
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- cc-by-nc
- Locations
- BMJ Open (publishedVersion, cc-by-nc)
- Europe PMC (PubMed Central) (publishedVersion, cc-by-nc)
- PubMed Central (publishedVersion, cc-by-nc)
- PubMed (publishedVersion)
- Adelaide Research & Scholarship (AR&S) (University of Adelaide) (submittedVersion, cc-by-nc)
- HighWire Press Open Archive (submittedVersion)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Education
- Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
- Health Sciences › Medicine › Epidemiology › Chronic Disease Management Strategies
- Keywords
- collaborative care, depression, diabetes mellitus, comorbid depression, glycemic control, HbA1c, depression remission, multidisciplinary care, chronic physical illness
- MeSH terms
- Blood Glucose, Depression, Diabetes Mellitus, Glycated Hemoglobin, Humans, Patient Care Team
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