Treatment adjustment and medication adherence for complex patients with diabetes, heart disease, and depression: a randomized controlled trial
Open accessAbstract
PURPOSE: Medication nonadherence, inconsistent patient self-monitoring, and inadequate treatment adjustment exacerbate poor disease control. In a collaborative, team-based, care management program for complex patients (TEAMcare), we assessed patient and physician behaviors (medication adherence, self-monitoring, and treatment adjustment) in achieving better outcomes for diabetes, coronary heart disease, and depression. METHODS: A randomized controlled trial was conducted (2007-2009) in 14 primary care clinics among 214 patients with poorly controlled diabetes (glycated hemoglobin [HbA(1c)] ≥8.5%) or coronary heart disease (blood pressure >140/90 mm Hg or low-density lipoprotein cholesterol >130 mg/dL) with coexisting depression (Patient Health Questionnaire-9 score ≥10). In the TEAMcare program, a nurse care manager collaborated closely with primary care physicians, patients, and consultants to deliver a treat-to-target approach across multiple conditions. Measures included medication initiation, adjustment, adherence, and disease self-monitoring. RESULTS: Pharmacotherapy initiation and adjustment rates were sixfold higher for antidepressants (relative rate [RR] = 6.20; P <.001), threefold higher for insulin (RR = 2.97; P <.001), and nearly twofold higher for antihypertensive medications (RR = 1.86, P <.001) among TEAMcare relative to usual care patients. Medication adherence did not differ between the 2 groups in any of the 5 therapeutic classes examined at 12 months. TEAMcare patients monitored blood pressure (RR = 3.20; P <.001) and glucose more frequently (RR = 1.28; P = .006). CONCLUSIONS: Frequent and timely treatment adjustment by primary care physicians, along with increased patient self-monitoring, improved control of diabetes, depression, and heart disease, with no change in medication adherence rates. High baseline adherence rates may have exerted a ceiling effect on potential improvements in medication adherence.
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In other similar studies, positive effects have been shown for people with depression, chronic obstructive pulmonary disease, asthma, diabetes and heart failure.
“In other similar studies, positive effects have been shown for people with depression 34 35 , chronic obstructive pulmonary disease 35 , asthma 35 36 , diabetes 35 36 and heart failure 36 .”
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 [34]
It is not clear whether all the components of the chronic care model are necessary, or whether some components are more effective than others.
“It is not clear whether all the components of the chronic care model are necessary, or whether some components are more effective than others 34 .”
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 [34]
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- Authors
- Lin, E. H. B., Von Korff, M., Ciechanowski, P., Peterson, D., Ludman, E. J., Rutter, C. M., Oliver, M., Young, B. A., Gensichen, J., McGregor, M., McCulloch, D. K., Wagner, E. H., & Katon, W. J.
- Affiliations
- Group Health Cooperative (US)
- University of Washington (US)
- Jena University Hospital (DE)
- Venue
- The Annals of Family Medicine
- Publisher
- Annals of Family Medicine
- Published
- 2012-01-01
- Volume
- 10
- Issue
- 1
- Pages
- 6-14
- ISSN
- 1544-1709 (ISSN-L)
- 1544-1717
- PMC
- PMC3262469
- OpenAlex
- W2117928199
- Cited by
- 150
- References
- 59
- Citations by year
- 2026: 2 · 2025: 4 · 2024: 8 · 2023: 11 · 2022: 8 · 2021: 7 · 2020: 5 · 2019: 5 · 2018: 9 · 2017: 11 · 2016: 15 · 2015: 20 · 2014: 17 · 2013: 16 · 2012: 9
- FWCI
- 17.14
- Type
- journal article
- Language
- en
- Open access
- diamond
- doi.org
- Locations
- The Annals of Family Medicine (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Kaiser Permanente
- National Institute of Mental Health (R01MH041739, K08MH069741, MH069741, MH041739)
- Topics
- Health Sciences › Medicine › Family Practice › Medication Adherence and Compliance
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Education
- Health Sciences › Medicine › Epidemiology › Chronic Disease Management Strategies
- Keywords
- medication adherence, treatment modification, medication non-adherence, diabetes mellitus, coronary artery disease, depression, chronic comorbidities, nursing care management, treat-to-target, antidepressant initiation, insulin initiation, antihypertensive drugs, self-measured blood pressure, self-monitoring of blood glucose, HbA1c, primary care
- MeSH terms
- Adult, Aged, Aged, 80 and over, Antidepressive Agents, Antihypertensive Agents, Cardiovascular Diseases, Depressive Disorder, Diabetes Mellitus, Drug Utilization, Female, Humans, Hypoglycemic Agents, Insulin, Male, Middle Aged, Patient Care Team, Physician-Patient Relations, Professional Practice, Regression Analysis, Self Care, Comorbidity, Drug Monitoring
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