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Depressive symptoms prior to and following insulin initiation in patients with type 2 diabetes mellitus : Prevalence, risk factors and effect on physician resource utilization
Dzida, Grzegorz; Karnieli, Eddy; Svendsen, Anne Louise; u. a. (2015): „Depressive symptoms prior to and following insulin initiation in patients with type 2 diabetes mellitus : Prevalence, risk factors and effect on physician resource utilization“. Amsterdam [u.a.]: Elsevier doi: 10.1016/j.pcd.2015.01.002.
Faculty/Professorship:
Title of the Journal:
Primary Care Diabetes
ISSN:
1751-9918
Publisher Information:
Year of publication:
2015
Volume:
9
Issue:
5
Pages:
Language:
English
Abstract:
Aims: To study the frequency and intensity of depressive symptoms and associations with physician resource utilisation following insulin initiation in patients with type 2 diabetes mellitus.
Methods: SOLVE was a 24-week observational study. In this sub-analysis of data from Poland, depressive symptoms were evaluated using the Patient Health Questionnaire (PHQ)-9.
Results: PHQ-9 was completed by 942 of 1169 patients (80.6%) at baseline, and 751 (64.2%) at both baseline and final (24-week) visit. PHQ-9 scores indicated depressive symptoms in 45.6% (n = 430) at baseline, and 27.2% (n = 223) at final visit. Mean PHQ-9 change was −2.38 [95% CI −2.73, −2.02], p < 0.001. Depressive symptoms at baseline (OR 6.32, p < 0.001), microvascular disease (OR 2.45, p = 0.016), number of physician contacts (OR 1.16, p = 0.009), and change in HbA1c (OR 0.60, p = 0.025) were independently associated with moderate/severe depressive symptoms at final visit. Patients with more severe depressive symptoms spent more time training to self-inject (p = 0.0016), self-adjust (p = 0.0023) and manage other aspects of insulin delivery (p < 0.0001). Patients with persistent depressive symptoms had more telephone contacts and dose changes at final visit than those without (both p < 0.05).
Methods: SOLVE was a 24-week observational study. In this sub-analysis of data from Poland, depressive symptoms were evaluated using the Patient Health Questionnaire (PHQ)-9.
Results: PHQ-9 was completed by 942 of 1169 patients (80.6%) at baseline, and 751 (64.2%) at both baseline and final (24-week) visit. PHQ-9 scores indicated depressive symptoms in 45.6% (n = 430) at baseline, and 27.2% (n = 223) at final visit. Mean PHQ-9 change was −2.38 [95% CI −2.73, −2.02], p < 0.001. Depressive symptoms at baseline (OR 6.32, p < 0.001), microvascular disease (OR 2.45, p = 0.016), number of physician contacts (OR 1.16, p = 0.009), and change in HbA1c (OR 0.60, p = 0.025) were independently associated with moderate/severe depressive symptoms at final visit. Patients with more severe depressive symptoms spent more time training to self-inject (p = 0.0016), self-adjust (p = 0.0023) and manage other aspects of insulin delivery (p < 0.0001). Patients with persistent depressive symptoms had more telephone contacts and dose changes at final visit than those without (both p < 0.05).
Keywords: ; ; ; ;
Type 2 diabetes
Depressive symptoms
Depression
PHQ-9
Healthcare resource utilisation
Peer Reviewed:
Yes:
International Distribution:
Yes:
Type:
Article
published:
April 5, 2016
Permalink
https://fis.uni-bamberg.de/handle/uniba/40236