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Integration of Diabetes and Depression Care Is Associated with Glucose Control in Midwestern Federally Qualified Health Centers.
- Source :
- JGIM: Journal of General Internal Medicine; Apr2021, Vol. 36 Issue 4, p978-984, 7p, 4 Charts
- Publication Year :
- 2021
-
Abstract
- Background: The 2016 American Diabetes Association position statement emphasized that psychosocial and medical care should be integrated and provided to all people with diabetes. Objective: To determine whether better integration of diabetes and depression care is associated with better glycemic control. Design: Cross-sectional surveys of Midwestern federally qualified health center (FQHC) leaders and primary care providers (PCPs) in 2016. Responses were linked to FQHC-level data on the percentage of patients with uncontrolled diabetes (glycated hemoglobin ≥ 9%; 75 mmol/mol). Participants: Midwest Clinicians' Network–affiliated FQHC leaders, and PCPs at the FQHCs. Main Measures: Multilevel models were used to determine associations between the percentage of patients with uncontrolled diabetes and FQHC and PCP characteristics; presence of diabetes and behavioral health care services; and PCPs' perception of the stage of integration between diabetes and depression care services based on the transtheoretical model (i.e., pre-contemplation, contemplation, preparation, action, or maintenance). Key Results: Response rates were 60% for the FQHC survey (N = 77) and 55% for the PCP survey (N = 538). In adjusted models, FQHCs in which PCPs perceived a higher stage of integration between diabetes and depression care had 3% fewer patients with uncontrolled diabetes per 1-level increase in integration stage (p = 0.01); on-site diabetes self-management education was associated with 7% fewer patients with uncontrolled diabetes (p < 0.01). Conclusions: At Midwestern FQHCs, a higher stage of perceived integration of diabetes and depression care was associated with better FQHC-level glycemic control. Future studies are needed to elucidate what defines integration of diabetes and depression care services. [ABSTRACT FROM AUTHOR]
Details
- Language :
- English
- ISSN :
- 08848734
- Volume :
- 36
- Issue :
- 4
- Database :
- Complementary Index
- Journal :
- JGIM: Journal of General Internal Medicine
- Publication Type :
- Academic Journal
- Accession number :
- 149787480
- Full Text :
- https://doi.org/10.1007/s11606-020-06585-5