title: Collaborative care for comorbid depression and diabetes: a systematic review and meta-analysis.
abstract: OBJECTIVE
  The collaborative care model is recommended for depression in adults with a chronic physical health problem like diabetes. We sought to systematically assess the effect of collaborative care on depression and glycaemia in adults with comorbid depression and diabetes to inform guidelines and practice.
  
  
  METHODS
  Systematic review and meta-analysis.
  
  
  METHODS
  We searched PubMed, Scopus, Cochrane Library, CINAHL, Health Source Nursing, MEDLINE, PsychINFO and reference lists of retrieved articles published before August 2013.
  
  
  METHODS
  Randomised controlled trials (RCTs) on collaborative care (ie, coordinated multidisciplinary model of care) for depression that reported the effects on depression and glycaemic outcomes in adults with comorbid clinically relevant depression and diabetes were eligible.
  
  
  METHODS
  Data on the mean difference in depression and glycaemic outcomes were extracted and pooled using random effects meta-analysis.
  
  
  RESULTS
  Seven RCTs included for review reported effects on depression outcomes in 1895 participants, and glycated haemoglobin (HbA1c) level in 1556 participants. Collaborative care significantly improved the depression score (standardised mean difference was -0.32 (95% CI -0.53 to -0.11); I(2)=79%) and HbA1c level (weighted mean difference was -0.33% (95% CI -0.66% to -0.00%); I(2)=72.9%) compared with control conditions. Depression remission did not predict better glycaemic control across studies.
  
  
  CONCLUSIONS
  Limited evidence from short-to-medium term RCTs predominantly conducted in the USA suggests that collaborative care for depression significantly improves both depression and glycaemia outcomes, independently, in people with comorbid depression and diabetes.
authors.affiliation: School of Nursing and Midwifery, University of Western Sydney, Campbelltown Campus, Campbelltown, New South Wales, Australia.
authors.forename: Evan
authors.initials: E
authors.lastname: Atlantis
authors.forename: Paul
authors.initials: P
authors.lastname: Fahey
authors.forename: Jann
authors.initials: J
authors.lastname: Foster
mesh_terms: D001786:Blood Glucose / Q000378:metabolism; D003863:Depression / Q000150:complications* / Q000628:therapy*; D003920:Diabetes Mellitus / Q000097:blood / Q000523:psychology* / Q000628:therapy*; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D010348:Patient Care Team
chemical_list: D001786:Blood Glucose; D006442:Glycated Hemoglobin
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