Taking a Team Approach to Treatment

Diabetes heart disease and depression improved through the use of team care

(RxWiki News) Chronic disorders impact millions of Americans. Treatment can sometimes be expensive, persistent, and ineffective. Recent research shows that a team approach to care can offer benefits.

A new study available through the upcoming Annals of Family Medicine highlights a potential solution.

Investigating TEAMcare, a collaborative treatment program, researchers found that customized treatments incorporating the patient as an active agent of change helped individuals with diabetes or heart disease who are also suffering from depression.

"Actively participate in self-healing efforts to aid recovery."

“In the TEAMcare program, a nurse care manager collaborated closely with primary care physicians, patients, and consultants to deliver a treat-to-target approach across multiple conditions,” explains corresponding author on the study, Elizabeth Lin, M.D., M.P.H., physician and researcher at Group Health Research Institute.

“It’s effective when nurses work with patients and health teams to manage care for depression and physical diseases together, using evidence-based guidelines.”

TEAMcare takes a team-based approach, involving a supervisory psychiatrist, primary care physician, nurse, and additional medical providers, as well as the patient at hand.

By teaching self-care skills necessary to efficiently control their disease, the patient can become an active participant in their road toward recovery.  

Dr. Lin and her team of thirteen conducted a randomized, controlled trial of 214 patients within 14 primary care facilities. Patients were being treated for comorbid depression with either poorly controlled diabetes or coronary heart disease. TEAMcare therapy served as the experimental group, while treatment as usual was used for the control.

The doctors measured success by analyzing medication initiation, adjustment, adherence, and self-monitoring within both groups. Physicians gathered data at the start of treatment, as well as at six and twelve months into treatment.

After one year, patients involved in TEAMcare were six times more likely to be on or adjusted to antidepressants, three times more likely to be using insulin for diabetes, and two times more likely to try antihypertensive medications for heart disease.

Although adherence was comparable amongst groups, the doctor recommends targeting TEAMcare towards increasing adherence rates in cases where patients have trouble following medication guidelines.

“Now we've shown why this team-based care is effective,” Lin expounds. “It's because it activates patients to check their own blood pressure and sugar more—and primary-care doctors to adjust patients' medications sooner and more often.”

Funded through the National Institute of Health, the team has a heavy interest in spreading the use of TEAMcare for patients with comorbid depression. Ask your healthcare provider about TEAMcare programs near you.

Reviewed by: 
Review Date: 
January 9, 2012