Integrating Depression and Diabetes Treatment in India
This randomized controlled pragmatic trial at four diabetes clinics in India evaluated the effectiveness of a multi-component collaborative practice change (MCCP) intervention compared to treatment as usual. 404 patients with type 2 diabetes and poor disease control and moderate-to-severe depression were randomized to either MCCP or treatment as usual. Primary outcome is the % of patients who achieved depression response AND clinically significant improvement in diabetes disease control after 24 months. MCCP consisted of non-mental health specialist care coordinators (CC) who supported patient self-management and tracked outcomes in a registry, and decision-support electronic health records (DS-EHR) and monthly case reviews with psychiatrist and diabetologist consultants to facilitate timely treatment adjustments. Primary collaborators are Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, USA and Madras Diabetes Research Foundation, Chennai, India. Funding is provided through an R01 MH100390.