Evidence mapPaperPMID 38360505Full record

Trial reportPrimary care diabetes2024

Association of collaborative care intervention features with depression and metabolic outcomes in the INDEPENDENT study: A mixed methods study.

Saria Hassan, Star Liu, Leslie C M Johnson, Shivani A Patel, Karl M F Emmert-Fees, Kara Suvada, Nikhil Tandon, Gumpeny Ramachandra Sridhar, Sosale Aravind, Subramani Poongothai and 4 more

Abstract readRandomized Controlled TrialMulticenter Study
In one paragraph

Trial report in Primary care diabetes, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Trial
  2. Trial
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

14 authors.

Saria HassanHubert Department of Global Health, Emory University, Atlanta, GA, USA; Emory Global Diabetes Research Center, Woodruff Health Sciences Center and Emory University, Atlanta, GA, USA; Department of Medicine, Emory University School of Medicine, Atlanta, GA, USA. Electronic address: Saria.hassan@emory.edu.
Star LiuHubert Department of Global Health, Emory University, Atlanta, GA, USA; Department of Biomedical Informatics and Data Science, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Leslie C M JohnsonDepartment of Family and Preventive Medicine, School of Medicine, Emory University, Atlanta, GA, USA; Emory Global Diabetes Research Center, Woodruff Health Sciences Center and Emory University, Atlanta, GA, USA.
Shivani A PatelHubert Department of Global Health, Emory University, Atlanta, GA, USA; Emory Global Diabetes Research Center, Woodruff Health Sciences Center and Emory University, Atlanta, GA, USA.
Karl M F Emmert-FeesHubert Department of Global Health, Emory University, Atlanta, GA, USA; Public Health and Prevention, Technical University of Munich, Munich, Germany.
Kara SuvadaDepartment of Epidemiology, Emory University, Atlanta, GA, USA.
Nikhil TandonDepartment of Endocrinology and Metabolism, All India Institute of Medical Sciences New Delhi, India.
Gumpeny Ramachandra SridharEndocrine and Diabetes Centre, Visakhapatnam, India.
Sosale AravindDiabetes Care and Research Center, Diacon Hospital, Bengaluru, India.
Subramani PoongothaiDepartment of Diabetology, Madras Diabetes Research Foundation and Dr. Mohan's Diabetes Specialties Centre, Chennai, India.
Ranjit Mohan AnjanaDepartment of Diabetology, Madras Diabetes Research Foundation and Dr. Mohan's Diabetes Specialties Centre, Chennai, India.
Viswanathan MohanDepartment of Diabetology, Madras Diabetes Research Foundation and Dr. Mohan's Diabetes Specialties Centre, Chennai, India.
Lydia ChwastiakDepartment of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, USA.
Mohammed K AliHubert Department of Global Health, Emory University, Atlanta, GA, USA; Department of Family and Preventive Medicine, School of Medicine, Emory University, Atlanta, GA, USA; Emory Global Diabetes Research Center, Woodruff Health Sciences Center and Emory University, Atlanta, GA, USA.

Funding

Technologies Advancing Translation - Regional CoreP30DK111024 · EMORY UNIVERSITY · 2025 to 2025
$775k
Johns Hopkins Training Program in Biomedical Informatics and Data ScienceT15LM013979 · JOHNS HOPKINS UNIVERSITY · 2025 to 2025
$453k
FIC NIH HHS R25 TW009337NHLBI NIH HHS K23 HL152368NIDDK NIH HHS P30 DK111024NIMH NIH HHS R01 MH100390NLM NIH HHS T15 LM013979
6 · The paper itself

Abstract

aimsThe INtegrating DEPrEssioN and Diabetes treatmENT (INDEPENDENT) trial tested a collaborative care model including electronic clinical decision support (CDS) for treating diabetes and depression in India. We aimed to assess which features of this clinically and cost-effective intervention were associated with improvements in diabetes and depression measures.

methodsPost-hoc analysis of the INDEPENDENT trial data (189 intervention participants) was conducted to determine each intervention feature's effect: 1. Collaborative case reviews between expert psychiatrists and the care team; 2. Patient care-coordinator contacts; and 3. Clinicians' CDS prompt modifications. Primary outcome was baseline-to-12-months improvements in diabetes control, blood pressure, cholesterol, and depression. Implementer interviews revealed barriers and facilitators of intervention success. Joint displays integrated mixed methods' results.

resultsHigh baseline HbA1c≥ 74.9 mmol/mol (9%) was associated with 5.72 fewer care-coordinator contacts than those with better baseline HbA1c (76.8 mmol/mol, 9.18%, p < 0.001). Prompt modification proportions varied from 38.3% (diabetes) to 1.3% (LDL). Interviews found that providers' and participants' visit frequencies were preference dependent. Qualitative data elucidated patient-level factors that influenced number of clinical contacts and prompt modifications explaining their lack of association with clinical outcomes.

conclusionOur mixed methods approach underlines the importance of the complementarity of different intervention features. Qualitative findings further illuminate reasons for variations in fidelity from the core model.

Indexed as

BiomarkersCooperative BehaviorDecision Support Systems, ClinicalDelivery of Health Care, IntegratedDepressionGlycated HemoglobinPatient Care TeamAdultAgedCost-Benefit AnalysisDiabetes MellitusDiabetes Mellitus, Type 2FemaleGlycemic ControlHumansIndiaBiomarkersGlycated Hemoglobinhemoglobin A1c protein, humanCollaborative careDepressionDiabetesIntegrationIntervention componentsLMIC

Identifiers

PMID38360505
PMCPMC11127790

What Socratic holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.