Study «Smith SM, Wallace E, O'Dowd T ym. Interventions fo...»1
Cochrane review included 18 RCTs for multimorbid patients, who receive care in a primary or community care setting. Nine studies focused on defined comorbid conditions with an emphasis on depression, diabetes and cardiovascular disease. The remaining studies focused on multimorbidity, generally in older people.
Population
In total, 1212 multimorbid patients with depression, diabetes and/or cardiovascular disease (5 studies) or depression and headache (1 study). Average age varied from 41 to 68 years.
Intervention
– Intervention duration varied from 2 weeks to 12 months.
– In four studies of six case managers coordinated collaborative care. Psychiatrist and/or psychologist was team member in three studies and in one study intervention was held by psychologist alone
– Interventions have personalised/individualised goal setting, care plans and support for self-care/self-management. Three studies emphasis psychological aspects and two of them offer therapy
Comparison
Control group patients had usual care and in one study enhanced primary care.
Outcome
Forest plot for depression scores were pooled from Hospital Anxiety and Depression Scale (HADS), Center for Epidemiologic Studies depression scale (CES), symptom checklist (SCL-D13), the Hopkins Symptom Checklist 20 (SCL 20) and Beck's Depression Inventory (BDI) scores from six studies.
– The standardised mean difference for depression scores was -0.41 (95% CI -0.63 to -0.20, I²=61%)
Study «Xie J, Deng W. Psychosocial intervention for patie...»2
Population
Meta-analysis was conducted in patients with type 2 diabetes mellitus (T2DM) and comorbid depression. In total, 31 RCTs composed of 2,616 patients, average age of patients in the intervention group was approximately 43 years, however, the average age of patients in most studies was between 50 and 70 years old
Intervention
– The treatment time ranged from 2 to 16 weeks
– All RCT studies included some elements of psychosocial support
– Group psychotherapy 11 studies
– Cognitive therapy 7 studies
– Psychological counselling 6 studies
– Individual psychotherapy 5 studies
– Relaxation therapy 2 studies
– In addition 6 studies included health education
Comparison
Conventional treatment
Outcome
The depression scores were Hamilton Depression Rating Scale (HDRS) or Self-Rating Depression Scale (SDS)
– depression symptoms with pooled standardized mean difference (SMD) of -1.50 (95% CI -1.83 to -1.18)