Penn researchers find treatment for diabetes and depression improves both
Brief adherence programs improve diabetes test results and depression symptoms
2012-01-11
(Press-News.org) (PHILADELPHIA) – Patients simultaneously treated for both Type 2 diabetes and depression improve medication compliance and significantly improve blood sugar and depression levels compared to patients receiving usual care, according to a new study by researchers from the Perelman School of Medicine at the University of Pennsylvania. Of patients receiving integrated care combined with a brief period of intervention to assist with adherence to prescribed medication regimens, more than 60 percent had improved blood sugar test results and 58 percent had reduced depression symptoms, compared to only 36 percent and 31 percent, respectively, of patients receiving usual care. The full results of the study are published in the January/February issue of the Annals of Family Medicine.
There is a link between depression and diabetes – as depression is a risk factor for diabetes, diabetes also increases the risk for the onset of depression. Not only is depression common in patients with diabetes, but it also contributes to poor adherence to medication regimens, which often results in worsening diabetes management.
"Though research demonstrates the link between depression and diabetes, few integrated programs are being implemented in practice," said lead author Hillary Bogner, MD, MSCE, an assistant professor of Family Medicine and Community Health in the Perelman School of Medicine, and a senior scholar at the Center for Clinical Epidemiology and Biostatistics, both at the University of Pennsylvania. "Our results demonstrate that integrated treatment for both conditions, combined with a brief program focused on adherence for primary care patients with Type 2 diabetes and depression can result in a significant improvement in clinical outcomes. We hope the findings will encourage the adoption of adherence programs aimed at improving outcomes."
Researchers randomly assigned participants to integrated care or usual care groups. Treatment for the integrated care group combined typical primary care with a brief medication adherence program. Primary care physicians and patients worked with integrated care managers to identify and address potential barriers to maintaining the prescribed medication regimen, such as the cost of medications, or a lack of social support. Integrated care managers developed individualized programs aimed at improving adherence to antidepressants and diabetes medication. Through the use of electronic monitors affixed to pill bottles, researchers were able track the precise date and time participants took their prescribed medications over the course of a 12-week period.
After 12 weeks of monitoring for medication adherence, 60.9 percent of patients who received the integrated approach were found to achieve improved blood sugar test results, compared to only 35.7 percent patients who received only the usual primary care. Additionally, patients in the integrated care group were also more likely to show signs of remission of depression in comparison with patients in the usual care group (58.7 percent vs. 30.7 percent, respectively).
"Our study calls for a greater emphasis within healthcare systems on the development and promotion of clinical programs to enhance medication adherence, particularly among patients with chronic medical conditions and depression," said Dr. Bogner. "An integrated approach to depression and type 2 diabetes treatment may facilitate adoption in practices with competing demands for limited resources."
INFORMATION:
Additional authors include Knashawn H. Morales, ScD, and Heather F. de Vries, MSPH, and Anne R. Cappola, MD, ScM, from Penn.
The current study was supported by an American Diabetes Association Clinical Research Award (1-09-CR-07). Dr. Bogner was supported by the National Institute of Mental Health grant (MH082799). Dr. Morales was supported by a National Institute of Mental Health mentored Career Development Award (MH073903). The research is based on a pilot study supported by the Penn Institute on Aging, where Drs. Bogner and Cappola are both fellows of the Institute.
END
ELSE PRESS RELEASES FROM THIS DATE:
2012-01-11
A new study provides the composite picture of the environmental distribution of oil and gas from the 2010 Deepwater Horizon spill in the Gulf of Mexico. It amasses a vast collection of available atmospheric, surface and subsurface chemical data to assemble a "mass balance" of how much oil and gas was released, where it went and the chemical makeup of the compounds that remained in the air, on the surface, and in the deep water.
The study, "Chemical data quantify Deepwater Horizon hydrocarbon flow rate and environmental distribution," is published online in the journal ...
2012-01-11
With a lack of effective treatments for Alzheimer's, most of us would think long and hard about whether we wanted to know years in advance if we were genetically predisposed to develop the disease. For researchers, however, such knowledge is a window into Alzheimer's disease's evolution.
Understanding the biological changes that occur during the clinically "silent" stage — the years before symptoms appear — provides clues about the causes of the disease and may offer potential targets for drugs that will stop it from progressing.
In a new study, researchers at UCLA ...
2012-01-11
University of California, Davis, researchers have proposed a radical new way of thinking about the chemical reactions between water and metal oxides, the most common minerals on Earth. Their work appears in the current issue of the journal Nature Materials.
The new paradigm could lead to a better understanding of corrosion and how toxic minerals leach from rocks and soil. It could also help in the development of "green" technology: new types of batteries, for example, or catalysts for splitting water to produce hydrogen fuel.
"This is a global change in how people should ...
2012-01-11
CHAMPAIGN, Ill. — A turning point in the history of life occurred 2 to 3 billion years ago with the unprecedented appearance and dramatic rise of molecular oxygen. Now researchers report they have identified an enzyme that was the first – or among the first – to generate molecular oxygen on Earth.
The new findings, reported in the journal Structure, build on more than a dozen previous studies that aim to track the molecular evolution of life by looking for evidence of that history in present-day protein structures. These studies, led by University of Illinois crop sciences ...
2012-01-11
SAN DIEGO — The investigational drug ganetespib, a synthetic second-generation Hsp90 inhibitor, slowed the growth of cancer cells taken from non-small cell lung cancer tumors with a mutation in the KRAS gene. The drug was even more active when combined with traditional lung cancer treatments and other investigational targeted therapies, according to preclinical study data.
David A. Proia, Ph.D., and Jaime Acquaviva, Ph.D., scientists at Synta Pharmaceuticals Corp., presented the data at the AACR-IASLC Joint Conference on Molecular Origins of Lung Cancer: Biology, Therapy ...
2012-01-11
SAN DIEGO -- Smoking may be associated with the development of molecular features of cancer in the large airway epithelium. In the small airway epithelium, molecular cancerization is associated with development of chronic obstructive pulmonary disease, according to recent data.
"We are striving to find the earliest molecular changes that are induced by environmental stressors — in this case, smoking," said Renat Shaykhiev, M.D., Ph.D., assistant professor of genetic medicine at Weill Cornell Medical College, who presented the findings at the AACR-IASLC Joint Conference ...
2012-01-11
Preventing mother to child transmission of HIV in Zimbabwe
In this week's PLoS Medicine, Andrea Ciaranello of Massachusetts General Hospital, Boston, USA and colleagues find, using a simulation model, that implementation of the latest WHO PMTCT (prevention of mother to child transmission of HIV) guidelines must take place in conjunction with improving access to PMTCT programs, increasing retention of women in care, and supporting adherence to drugs, in order to eliminate pediatric HIV in Zimbabwe.
The authors say: "Although PMTCT uptake in low- and middle-income countries ...
2012-01-11
Limited use of compulsory licensing of pharmaceuticals to protect public health
Reed Beall and Randall Kuhn of the University of Denver, USA describe in this week's PLoS Medicine their findings from an analysis of use of compulsory licenses for pharmaceutical products by World Trade Organization members since 1995. Specifically, the authors investigated the impact of the 2001 Doha Declaration on trends in compulsory licensing of pharmaceuticals. They highlight the need for further systematic evaluation of global health agreements.
###Funding: No direct funding was received ...
2012-01-11
Long-term consequences of venous thrombosis
Linda Flinterman of Leiden University, the Netherlands and colleagues report in this week's PLoS Medicine on the long-term mortality rate for individuals who have experienced a first venous thrombosis or pulmonary embolism. They describe an ongoing elevated risk of death for individuals who had experienced a venous thrombosis or pulmonary embolism as compared to controls, for up to eight years after the event.
The authors say: "To our knowledge, this has been the first study to calculate mortality rates compared with the general ...
2012-01-11
Jason Nickerson and Amir Attaran of the University of Ottawa, Canada examine in this week's PLoS Medicine the vast inequities in medical pain relief around the world, arguing that the imbalance has arisen from restrictive drug laws designed to prevent access to illegal substances, and proposing that the global control of licit narcotics be shifted from the International Narcotic Control Board to WHO.
The authors say: "Transferring the public health responsibility for controlled medicines from INCB to WHO would end the impossibly contradictory situation in which INCB ...
LAST 30 PRESS RELEASES:
[Press-News.org] Penn researchers find treatment for diabetes and depression improves both
Brief adherence programs improve diabetes test results and depression symptoms
