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Team Treatment Helps Depression, Chronic Disease

Patients Have Better Outcomes With Team Approach to Managing Care, Study Finds

Depression and Chronic Disease continued...

The TEAMcare patients were assigned a doctor-supervised nurse coach who coordinated their medical care. The nurses screened the patients for depression and recommended adjustments in blood pressure, blood sugar, cholesterol, and depression medications as needed. 

Nurse coaches also worked with patients to set and achieve attainable health goals. 

During the yearlong study, patients with the nurse coaches had more frequent adjustments in insulin and in medications for depression, blood pressure, cholesterol, and blood sugar than patients who got standard care. 

They also achieved better control of their depression, diabetes, and heart disease and reported better quality of life and more satisfaction with medical care. 

Nurse coach Susan Ruedebusch, RN, who has been a diabetes educator with Group Health for 27 years, says she has rarely seen such dramatic improvements in patients. 

She ended up coaching several of her previous patients who had never made much progress before entering the study. 

“We entered into a totally different relationship, where the patients set the agenda for the goals they wanted to achieve,” she says. “The improvement I saw was amazing.”

Potential Reduction in Health Costs

The average cost of the collaborative care intervention was about $1,200 for two years of nurse coaching.

Katon and colleagues are currently conducting a cost-benefit analysis of the intervention, but the researcher says the savings to the health care system associated with better management of chronic disease could be huge.

The average cost of treating a patient with multiple chronic diseases is about $10,000 annually, Katon says.

“Clearly, this is a timely intervention,” he says. “Over the next decade, Medicare costs are going to skyrocket. We are going to have to do something or it will break the bank.”

Depression and diabetes researcher Briana Mezuk, PhD, of Virginia Commonwealth University says the collaborative care model is increasingly being used by managed care groups to treat chronic disease.

She adds that the importance of integrating depression screening and treatment into the management of chronic disease is also being realized.

“We know that if we help patients manage depression they will take better care of themselves,” she says. “They are more likely to take their medications and do the other things their doctors want them to do.”

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