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Hogervorst S, Adriaanse MC, Vervloet M, Teichert M, Beckeringh JJ, van Dijk L, Hugtenburg JG. A survey on the implementation of clinical medication reviews in community pharmacies within a multidisciplinary setting. BMC Health Serv Res 2024; 24:575. [PMID: 38702640 PMCID: PMC11067219 DOI: 10.1186/s12913-024-11013-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Accepted: 04/18/2024] [Indexed: 05/06/2024] Open
Abstract
BACKGROUND Polypharmacy is common in chronic medication users, which increases the risk of drug related problems. A suitable intervention is the clinical medication review (CMR) that was introduced in the Netherlands in 2012, but the effectiveness might be hindered by limited implementation in community pharmacies. Therefore our aim was to describe the current implementation of CMRs in Dutch community pharmacies and to identify barriers to the implementation. METHODS An online questionnaire was developed based on the Consolidated Framework for Implementation Research (CFIR) and consisted of 58 questions with open ended, multiple choice or Likert-scale answering options. It was sent out to all Dutch community pharmacies (n = 1,953) in January 2021. Descriptive statistics were used. RESULTS A total of 289 (14.8%) community pharmacies filled out the questionnaire. Most of the pharmacists agreed that a CMR has a positive effect on the quality of pharmacotherapy (91.3%) and on medication adherence (64.3%). Pharmacists structured CMRs according to available selection criteria or guidelines (92%). Pharmacists (90%) believed that jointly conducting a CMR with a general practitioner (GP) improved their mutual relationship, whereas 21% believed it improved the relationship with a medical specialist. Lack of time was reported by 43% of pharmacists and 80% (fully) agreed conducting CMRs with a medical specialist was complicated. Most pharmacists indicated that pharmacy technicians can assist in performing CMRs, but they rarely do in practice. CONCLUSIONS Lack of time and suboptimal collaboration with medical specialists are the most important barriers to the implementation of CMRs.
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Affiliation(s)
- S Hogervorst
- Department of Health Sciences, Faculty of Science, Vrije Universiteit, Amsterdam, The Netherlands
- Amsterdam Public Health Research Institute, Amsterdam UMC, Location VUMC, De Boelelaan 1117, Amsterdam, 1081 HV, The Netherlands
| | - M C Adriaanse
- Department of Health Sciences, Faculty of Science, Vrije Universiteit, Amsterdam, The Netherlands
- Amsterdam Public Health Research Institute, Amsterdam UMC, Location VUMC, De Boelelaan 1117, Amsterdam, 1081 HV, The Netherlands
| | - M Vervloet
- Department of Pharmaceutical Care, Nivel, Institute for Health Services Research, Utrecht, The Netherlands.
| | - M Teichert
- Department of Clinical Pharmacy & Toxicology, Leiden University Medical Center, Leiden, The Netherlands
| | | | - L van Dijk
- Department of Pharmaceutical Care, Nivel, Institute for Health Services Research, Utrecht, The Netherlands
- Faculty of Science and Engineering. PharmacoTherapy, Epidemiology and Economics - Groningen, Research Institute of Pharmacy, Groningen, The Netherlands
| | - J G Hugtenburg
- Amsterdam Public Health Research Institute, Amsterdam UMC, Location VUMC, De Boelelaan 1117, Amsterdam, 1081 HV, The Netherlands
- Department of Clinical Pharmacology and Pharmacy, Amsterdam UMC, Location VUMC, De Boelelaan 1117, 1081HV, Amsterdam, The Netherlands
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van Dijk SEM, Pols AD, Adriaanse MC, van Marwijk HWJ, van Tulder MW, Bosmans JE. Cost-effectiveness of a stepped care program to prevent depression among primary care patients with diabetes mellitus type 2 and/or coronary heart disease and subthreshold depression in comparison with usual care. BMC Psychiatry 2021; 21:402. [PMID: 34389017 PMCID: PMC8361858 DOI: 10.1186/s12888-021-03367-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Accepted: 06/10/2021] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Patients with diabetes mellitus type 2 (DM2) and/or coronary heart disease (CHD) are at high risk to develop major depression. Preventing incident major depression may be an important tool in reducing the personal and societal burden of depression. The aim of the current study was to assess the cost-effectiveness of a stepped care program to prevent major depression (Step-Dep) in diabetes mellitus type 2 and/or coronary heart disease patients with subthreshold depression in comparison with usual care. METHODS An economic evaluation with 12 months follow-up was conducted alongside a pragmatic cluster-randomized controlled trial from a societal perspective. Participants received care as usual (n = 140) or Step-Dep (n = 96) which consisted of four sequential treatment steps: watchful waiting, guided self-help, problem solving treatment and referral to a general practitioner. Primary outcomes were quality-adjusted life years (QALYs) and cumulative incidence of major depression. Costs were measured every 3 months. Missing data was imputed using multiple imputation. Uncertainty around cost-effectiveness outcomes was estimated using bootstrapping and presented in cost-effectiveness planes and acceptability curves. RESULTS There were no significant differences in QALYs or depression incidence between treatment groups. Secondary care costs (mean difference €1644, 95% CI €344; €3370) and informal care costs (mean difference €1930, 95% CI €528; €4089) were significantly higher in the Step-Dep group than in the usual care group. The difference in total societal costs (€1001, 95% CI €-3975; €6409) was not statistically significant. The probability of the Step-Dep intervention being cost-effective was low, with a maximum of 0.41 at a ceiling ratio of €30,000 per QALY gained and 0.32 at a ceiling ratio of €0 per prevented case of major depression. CONCLUSIONS The Step-Dep intervention is not cost-effective compared to usual care in a population of patients with DM2/CHD and subthreshold depression. Therefore, widespread implementation cannot be recommended. TRIAL REGISTRATION The trial was registered in the Netherlands Trial Register ( NTR3715 ).
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Affiliation(s)
- S. E. M. van Dijk
- grid.16872.3a0000 0004 0435 165XDepartment of Health Sciences, Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam Public Health research institute, De Boelelaan 1085, 1081 HV Amsterdam, the Netherlands
| | - A. D. Pols
- grid.16872.3a0000 0004 0435 165XDepartment of Health Sciences, Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam Public Health research institute, De Boelelaan 1085, 1081 HV Amsterdam, the Netherlands ,grid.16872.3a0000 0004 0435 165XDepartment of General Practice and Elderly Medicine and the Amsterdam Public Health research institute, VU University Medical Centre, Amsterdam, The Netherlands
| | - M. C. Adriaanse
- grid.16872.3a0000 0004 0435 165XDepartment of Health Sciences, Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam Public Health research institute, De Boelelaan 1085, 1081 HV Amsterdam, the Netherlands
| | - H. W. J. van Marwijk
- grid.16872.3a0000 0004 0435 165XDepartment of General Practice and Elderly Medicine and the Amsterdam Public Health research institute, VU University Medical Centre, Amsterdam, The Netherlands ,Department of Primary Care and Public Health Medicine, Brighton, UK ,Sussex Medical School, Brighton, UK
| | - M. W. van Tulder
- grid.16872.3a0000 0004 0435 165XDepartment of Health Sciences, Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam Public Health research institute, De Boelelaan 1085, 1081 HV Amsterdam, the Netherlands
| | - J. E. Bosmans
- grid.16872.3a0000 0004 0435 165XDepartment of Health Sciences, Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam Public Health research institute, De Boelelaan 1085, 1081 HV Amsterdam, the Netherlands
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Nouwen A, Adriaanse MC, van Dam K, Iversen MM, Viechtbauer W, Peyrot M, Caramlau I, Kokoszka A, Kanc K, de Groot M, Nefs G, Pouwer F. Longitudinal associations between depression and diabetes complications: a systematic review and meta-analysis. Diabet Med 2019; 36:1562-1572. [PMID: 31215077 DOI: 10.1111/dme.14054] [Citation(s) in RCA: 134] [Impact Index Per Article: 26.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/17/2019] [Indexed: 01/10/2023]
Abstract
To conduct a systematic review and meta-analysis of longitudinal studies assessing the bi-directional association between depression and diabetes macrovascular and microvascular complications. Embase, Medline and PsycINFO databases were searched from inception through 27 November 2017. A total of 4592 abstracts were screened for eligibility. Meta-analyses used multilevel random/mixed-effects models. Quality was assessed using the Newcastle-Ottawa scale. Twenty-two studies were included in the systematic review. Sixteen studies examined the relationship between baseline depression and incident diabetes complications, of which nine studies involving over one million participants were suitable for meta-analysis. Depression was associated with an increased risk of incident macrovascular (HR = 1.38; 95% CI: 1.30-1.47) and microvascular disease (HR = 1.33; 95% CI: 1.25-1.41). Six studies examined the association between baseline diabetes complications and subsequent depression, of which two studies involving over 230 000 participants were suitable for meta-analysis. The results showed that diabetes complications increased the risk of incident depressive disorder (HR = 1.14; 95% CI: 1.07-1.21). The quality analysis showed increased risk of bias notably in the representativeness of selected cohorts and ascertainment of exposure and outcome. Depression in people with diabetes is associated with an increased risk of incident macrovascular and microvascular complications. The relationship between depression and diabetes complications appears bi-directional. However, the risk of developing diabetes complications in depressed people is higher than the risk of developing depression in people with diabetes complications. The underlying mechanisms warrant further research.
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Affiliation(s)
- A Nouwen
- Middlesex University, London, UK
| | | | | | - M M Iversen
- Western Norway University of Applied Sciences, Bergen, Norway
| | | | - M Peyrot
- Western Norway University of Applied Sciences, Bergen, Norway
- Loyola University Maryland, Baltimore, USA
| | | | | | - K Kanc
- Jazindiabetes (Diabetes & Me), Private Diabetes Centre, Ljubljana, Slovenia
| | - M de Groot
- Indiana University School of Medicine, Indianapolis, USA
| | - G Nefs
- Tilburg University, The Netherlands
- Radboud University Medical Center, Nijmegen, The Netherlands
- Diabeter, Rotterdam, The Netherlands
| | - F Pouwer
- University of Southern Denmark, Odense, Denmark
- STENO Diabetes Center Odense, Odense, Denmark
- School of Psychology, Deakin University, Geelong, Australia
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van der Pols-Vijlbrief R, Dekker JM, Stehouwer CD, de Boer MR, Nijpels G, Snoek FJ, Adriaanse MC. Symptom burden and its association with change in glucose metabolism status over a 7-year period: the Hoorn Study. Diabet Med 2014; 31:747-53. [PMID: 24494697 DOI: 10.1111/dme.12406] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2013] [Revised: 12/02/2013] [Accepted: 01/28/2014] [Indexed: 12/15/2022]
Abstract
AIMS To study symptom burden among older people and its associations with change in glucose metabolism status over a 7-year period. METHODS We conducted a prospective population-based cohort study among 397 older people. We used the revised Diabetes Symptom Checklist to assess symptom burden. Glucose metabolism status was determined using an oral glucose tolerance test. Analyses were adjusted for multiple confounders, including cardiovascular risk and risk of depression (Center for Epidemiological Studies Depression Scale score ≥ 16). RESULTS Revised Diabetes Symptom Checklist total scores (range 0-100) increased slightly over time among people with normal glucose metabolism (mean difference β1.04; P = 0.04) and those with impaired glucose metabolism (β1.96; P = 0.01), but not among people with Type 2 diabetes (β0.46; P = 0.55). These associations between symptom burden and glucose status were attenuated after full adjustment for multiple confounders and remained statistically significant for those with impaired glucose status. Linear mixed models showed significant mean differences in revised Diabetes Symptom Checklist total scores over time when comparing people with Type 2 diabetes with those with normal or impaired glucose metabolism, but not when comparing subjects with impaired vs normal glucose metabolism; these results did not alter after full adjustment. CONCLUSIONS Symptom burden increased gradually over time in the people with impaired glucose metabolism and those with normal glucose metabolism, but not in patients with Type 2 diabetes over a 7-year follow-up period.
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Affiliation(s)
- R van der Pols-Vijlbrief
- Department of Health Sciences, Faculty of Earth and Life Sciences, VU University, Amsterdam, The Netherlands; EMGO+ Institute for Health and Care Research, VU University Medical Centre, Amsterdam, The Netherlands
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van Sloten TT, Schram MT, Adriaanse MC, Dekker JM, Nijpels G, Teerlink T, Scheffer PG, Pouwer F, Schalkwijk CG, Stehouwer CDA, Henry RMA. Endothelial dysfunction is associated with a greater depressive symptom score in a general elderly population: the Hoorn Study. Psychol Med 2014; 44:1403-1416. [PMID: 23942242 DOI: 10.1017/s0033291713002043] [Citation(s) in RCA: 53] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
BACKGROUND Endothelial dysfunction (ED), low-grade inflammation (LGI) and oxidative stress (OxS) may be involved in the pathobiology of depression. Previous studies on the association of these processes in depression have yielded contradictory results. We therefore investigated comprehensively, in a population-based cohort study, the association between ED, LGI and OxS on the one hand and depressive symptoms on the other. METHOD We used data from the Hoorn Study and determined biomarkers of ED [flow-mediated dilatation (FMD), von Willebrand factor, soluble intercellular adhesion molecule 1 (sICAM-1), soluble vascular cell adhesion molecule 1, soluble thrombomodulin and soluble endothelial selectin], LGI [C-reactive protein, tumour necrosis factor-α, interleukin 6, interleukin 8, serum amyloid A, myeloperoxidase (MPO) and sICAM-1] and OxS (oxidized low density lipoprotein and MPO). Depressive symptoms were quantified by the Center for Epidemiologic Studies Depression Scale (CES-D) questionnaire (n = 493; age 68 years; 49.9% female). Regression analyses were performed with the use of biomarker Z scores. Adjustments were made for age, sex and glucose metabolism status (cohort stratification variables) and prior cardiovascular disease, hypertension, waist-to-hip ratio, cholesterol levels, education level, physical activity, dietary habits, and the use of antihypertensive and/or lipid-lowering medication and/or metformin (potential confounders). RESULTS After adjustment for age, sex and glucose metabolism status, one standard deviation increase in the ED Z score was associated with a 1.9 [95% confidence interval (CI) 0.7-3.1] higher CES-D score. Additional adjustments did not materially change this result. LGI and OxS were not associated with the CES-D score. CONCLUSIONS ED, as quantified by an array of circulating biomarkers and FMD, was independently associated with depressive symptoms. This study supports the hypothesis that ED plays an important role in the pathobiology of depression.
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Affiliation(s)
- T T van Sloten
- Department of Medicine, Maastricht University Medical Centre, The Netherlands
| | - M T Schram
- Department of Medicine, Maastricht University Medical Centre, The Netherlands
| | - M C Adriaanse
- EMGO Institute for Health and Care Research, VU University Medical Centre, Amsterdam, The Netherlands
| | - J M Dekker
- EMGO Institute for Health and Care Research, VU University Medical Centre, Amsterdam, The Netherlands
| | - G Nijpels
- EMGO Institute for Health and Care Research, VU University Medical Centre, Amsterdam, The Netherlands
| | - T Teerlink
- Metabolic Laboratory, Department of Clinical Chemistry, VU University Medical Centre, Amsterdam, The Netherlands
| | - P G Scheffer
- Metabolic Laboratory, Department of Clinical Chemistry, VU University Medical Centre, Amsterdam, The Netherlands
| | - F Pouwer
- Centre of Research on Psychology in Somatic Diseases, Department of Medical Psychology and Neuropsychology, Tilburg University, The Netherlands
| | - C G Schalkwijk
- Department of Medicine, Maastricht University Medical Centre, The Netherlands
| | - C D A Stehouwer
- Department of Medicine, Maastricht University Medical Centre, The Netherlands
| | - R M A Henry
- Department of Medicine, Maastricht University Medical Centre, The Netherlands
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Verkleij SPJ, Adriaanse MC, Wendel-Vos GCW, Schuit AJ. Longitudinal relation between weight change and quality of life in a community-based population: a prospective cohort study. Eur J Public Health 2012; 23:285-90. [DOI: 10.1093/eurpub/cks058] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Adriaanse MC, Bosmans JE. Diabetes prevalence, diabetes regimen and co-morbidity in depressed patients compared with non-depressed patients in primary care in the Netherlands. Diabet Med 2010; 27:718-22. [PMID: 20546295 DOI: 10.1111/j.1464-5491.2010.03002.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
AIMS To assess the prevalence of diabetes in depressed patients compared with non-depressed matched controls and to compare diabetes regimen and co-morbidity in depressed patients with diabetes vs. non-depressed patients with diabetes in primary care in the Netherlands. METHODS A retrospective case-control study over 3 years (2002-2004). Data for depressed patients (n = 7128) and non-depressed matched controls (n = 23,772) were available from an electronic medical record system of 20 general practices organized in one large primary care organization in the Netherlands. Matching was based on year and month of birth, sex and general practitioner. Diabetes, diabetes regimen (i.e. oral glucose medication, insulin or both) and co-morbidity were defined using Anatomical Therapeutic Chemical classification codes of delivered medication. RESULTS The prevalence of diabetes was 5.5% (n = 393) among depressed patients, which was 2.6 times higher than in non-depressed matched controls where the figure was 2.1% (n = 494; P < 0.001). Diabetes regimen, i.e. the proportions of subjects on oral glucose medication, insulin or both did not differ among depressed patients with diabetes (51, 27 and 22%, respectively) compared with non-depressed patients with diabetes (51, 30, 19%; P = 0.53). Co-morbidity was significantly more prevalent among depressed patient with diabetes than in non-depressed patients with diabetes. CONCLUSIONS Compared with non-depressed matched controls, adults with treated depression have almost three times higher rates of diabetes. Depressed patients with diabetes had more co-morbidities compared with non-depressed patients with diabetes, whereas diabetes regimen did not differ.
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Affiliation(s)
- M C Adriaanse
- Section of Prevention and Public Health, Department of Health Sciences and EMGO Institute for Health and Care Research, VU University Amsterdam, Amsterdam, the Netherlands.
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Adriaanse MC, Dekker JM, Heine RJ, Snoek FJ, Beekman AJ, Stehouwer CD, Bouter LM, Nijpels G, Pouwer F. Symptoms of depression in people with impaired glucose metabolism or Type 2 diabetes mellitus: The Hoorn Study. Diabet Med 2008; 25:843-9. [PMID: 18513303 DOI: 10.1111/j.1464-5491.2008.02464.x] [Citation(s) in RCA: 43] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To study the prevalence and risk factors of depressive symptoms, comparing subjects with normal glucose metabolism (NGM), impaired glucose metabolism (IGM) or Type 2 diabetes mellitus (DM2). RESEARCH DESIGN AND METHODS Cross-sectional data from a population-based cohort study conducted among 550 residents (276 men and 274 women) of the Hoorn region, the Netherlands. Levels of depressive symptoms were measured using the Centre for Epidemiologic Studies Depression Scale (CES-D score > or = 16). Glucose metabolism status was determined by means of fasting and post-load glucose levels. RESULTS The prevalence of depressive symptoms in men with NGM, IGM and DM2 was 7.7, 7.0 and 15.0% (P = 0.19) and for women 7.7, 23.1 and 19.7% (P < 0.01), respectively. Depression was significantly more common in women with IGM [odds ratio (OR) = 3.60, 95% confidence interval (CI) = 1.57 to 8.28] and women with DM2 (OR = 3.18, 95% CI = 1.31 to 7.74). In men, depression was not associated with IGM (OR = 0.90, 95% CI = 0.32 to 2.57) and non-significantly more common in DM2 (OR = 2.04, 95% CI = 0.75 to 5.49). Adjustment for cardiovascular risk factors, cardiovascular disease and diabetes symptoms reduced the strength of these associations. CONCLUSIONS Depressive symptoms are more common in women with IGM, but not men. Adjustment for cardiovascular risk factors, cardiovascular disease and diabetes symptoms partially attenuated these associations, suggesting that these variables could be intermediate factors.
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Affiliation(s)
- M C Adriaanse
- Institute of Health Sciences, Faculty of Earth and Life Sciences, VU University Amsterdam, the Netherlands
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Adriaanse MC, Dekker JM, Nijpels G, Heine RJ, Snoek FJ, Pouwer F. Associations between depressive symptoms and insulin resistance: the Hoorn Study. Diabetologia 2006; 49:2874-7. [PMID: 17066302 DOI: 10.1007/s00125-006-0500-4] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2006] [Accepted: 09/12/2006] [Indexed: 10/24/2022]
Abstract
AIMS/HYPOTHESIS The association between depression and insulin resistance has been investigated in only a few studies, with contradictory results reported. The aim of this study was to determine whether the association between symptoms of depression and insulin resistance varies across glucose tolerance status and between men and women. SUBJECTS AND METHODS Cross-sectional data from a population-based cohort study in Hoorn, a medium-sized town in the Netherlands, were analysed. The study sample consisted of 541 men and women aged 55-75 years, of whom 260 had NGT, 164 had IGT and 117 had established type 2 diabetes mellitus. Main outcome measures were insulin resistance defined by the homeostasis model assessment for insulin resistance (HOMA-IR) and symptoms of depression using the Centre for Epidemiologic Studies Depression Scale (CES-D). RESULTS In the total sample, we found a weak positive correlation between the depressive symptoms CED-D scores and HOMA-IR scores (r (s) = 0.156, p < 0.001). Even weaker associations were found in subjects with NGT (r (s) = 0.041, p=0.509), in subjects with IGT (r (s) = 0.112, p = 0.160) and in subjects with type 2 diabetes (r (s) = 0.007, p = 0.942). The association between depressive symptoms and insulin resistance was similar for men and women. CONCLUSIONS/INTERPRETATION We found only weak associations between depressive symptoms and insulin resistance, which did not differ among different glucose metabolism subgroups or between men and women.
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Affiliation(s)
- M C Adriaanse
- Faculty of Earth and Life Sciences, Institute of Health Sciences, Vrije University Amsterdam, De Boelelaan 1085, 1081 HV, Amsterdam, The Netherlands.
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Adriaanse MC, Dekker JM, Spijkerman AMW, Twisk JWR, Nijpels G, van der Ploeg HM, Heine RJ, Snoek FJ. Health-related quality of life in the first year following diagnosis of Type 2 diabetes: newly diagnosed patients in general practice compared with screening-detected patients. The Hoorn Screening Study. Diabet Med 2004; 21:1075-81. [PMID: 15384953 DOI: 10.1111/j.1464-5491.2004.01277.x] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
AIMS To determine health-related quality of life (HRQoL) in the first year following diagnosis of Type 2 diabetes among newly diagnosed patients in general practice compared with patients detected by targeted population screening. METHODS The study population consisted of 49 newly diagnosed patients in general practice and 116 screening-detected patients. HRQoL was operationalized as symptom distress, perceived health status and emotional well-being, that were assessed prospectively approximately 2 weeks, 6 months and 12 months after the diagnosis of Type 2 diabetes, with the Type 2 Diabetes Symptom Checklist (DSC-type 2), the Short Form 36 (SF-36) and the Well-Being Questionnaire (W-BQ12), respectively. RESULTS The DSC-type 2 total score (range 0-4) improved significantly within newly diagnosed patients in general practice (median at approximately 2 weeks, 6 months and 12 months; 0.56, 0.21, 0.26; P = 0.000) and not within screening-detected patients (0.24, 0.24, 0.29; P = 0.093). Descriptives showed that newly diagnosed patients in general practice compared with screening-detected patients had consistently worse mean scores on all SF-36 mental health subscales Social Functioning, Role Emotional, Mental Health, Vitality, and all W-BQ12 scales at each time point. The differences were statistically significant for Role Emotional, Mental Health, Vitality (SF-36), and General well-being (W-BQ12). The SF-36 General Health (F = 3.7, P = 0.028) and Vitality (F = 4.5, P = 0.012) scores of newly diagnosed patients in general practice improved significantly over time, compared with screening-detected patients. CONCLUSIONS Newly diagnosed patients in general practice compared with screening-detected patients reported more diabetes-related symptom distress shortly after the diagnosis, and a consistently worse mental health status at each time point. Improved Vitality scores in newly diagnosed patients in general practice in the first year following diagnosis of Type 2 diabetes suggest a positive effect of diabetes treatment on HRQoL.
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Affiliation(s)
- M C Adriaanse
- Institute for Research in Extramural Medicine (EMGO-Institute), VU University Medical Centre, Amsterdam, the Netherlands.
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Adriaanse MC, Snoek FJ, Dekker JM, Spijkerman AMW, Nijpels G, Twisk JWR, van der Ploeg HM, Heine RJ. No substantial psychological impact of the diagnosis of Type 2 diabetes following targeted population screening: The Hoorn Screening Study. Diabet Med 2004; 21:992-8. [PMID: 15317604 DOI: 10.1111/j.1464-5491.2004.01276.x] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
AIMS To examine the impact of the diagnosis of Type 2 diabetes on psychological well-being and perceived health status in subjects who participated in a targeted population-screening programme. METHODS This study was conducted within the framework of a screening project in the general (aged 50-75 years) Dutch population. The final study population consisted of 259 subjects with a high-risk score on the Symptom Risk Questionnaire; 116 of whom were subsequently detected with Type 2 diabetes and 143 who were non-diabetic. The impact was assessed approximately 2 weeks (shortly) and 6 and 12 months after the diagnosis, using the 12-item Well-Being Questionnaire (W-BQ12) and the Medical Outcomes Study Short Form 36 (SF-36), respectively. Analyses of co-variance (ancova) were used. RESULTS Approximately 2 weeks after the diagnosis, no significant mean differences were found on either the W-BQ12 or the SF-36, between the screening-detected Type 2 diabetes subjects and the non-diabetic subjects. Six months after the diagnosis, we found lower scores in the screening-detected Type 2 diabetes subjects compared with the non-diabetic subjects on the SF-36 dimensions Role Physical (mean difference (95% CI); -8.2 (-16.2; -0.1); P = 0.046) and Role Emotional (mean difference (95% CI); -7.9 (-15.3; -0.5); P = 0.038). One year after the test results, no significant mean differences were found between both groups on either instrument (W-BQ12; SF-36). CONCLUSIONS The diagnosis of Type 2 diabetes has no substantial adverse or positive effect on psychological well-being and perceived health status, shortly, and 6 and 12 months after the diagnosis.
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Affiliation(s)
- M C Adriaanse
- Institute for Research in Extramural Medicine (EMGO-Institute), VU University Medical Center, Amsterdam, the Netherlands.
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Adriaanse MC, Snoek FJ, Dekker JM, Spijkerman AMW, Nijpels G, van der Ploeg HM, Heine RJ. Perceived risk for Type 2 diabetes in participants in a stepwise population-screening programme. Diabet Med 2003; 20:210-5. [PMID: 12675665 DOI: 10.1046/j.1464-5491.2003.00901.x] [Citation(s) in RCA: 43] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
AIMS To determine the risk perception of Type 2 diabetes in participants in a stepwise population-screening programme. METHODS This study was carried out within the framework of a stepwise Type 2 diabetes population screening in the general (age 50-75 years) Dutch population. Main outcome measures were perceived risk of having diabetes and perceived seriousness of diabetes, based on a self-report questionnaire, completed before being informed about the diagnosis (Type 2 diabetes yes/no) of the screening procedure. Among 7736 participants, the risk perception of 217 screening-detected participants was compared with 4435 with a low-risk profile for undiagnosed Type 2 diabetes. RESULTS Of 7736 participants, 43.5% could not give an estimate of their risk of having diabetes, 31.2% estimated their risk to be 0% and 25.3% estimated their risk to be 10% or higher. Compared with 4435 participants with an objectively low risk profile, 217 screening-detected participants were more likely to answer 'I do not know' (52.4% vs. 40.1%, P < 0.001), perceived their risk less often to be 0% (19.3% vs. 34.7%, P < 0.001), and slightly more often perceived their risk to be 10% or higher (28.3% vs. 25.2%, P < 0.001). Overall, more than half of the total population, including both participants with a low risk profile and the screening-detected participants, perceived diabetes as a (very) serious disease. Higher age, obesity and taking anti-hypertensive drugs did not translate into a higher perceived risk. CONCLUSIONS Among screening-detected participants the seriousness of Type 2 diabetes was generally acknowledged, whilst the perceived risk of having Type 2 diabetes was low, despite the presence of risk factors.
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Affiliation(s)
- M C Adriaanse
- Institute for Research in Extramural Medicine (EMGO-Institute), VU University Medical Centre, Amsterdam, the Netherlands.
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Pouwer F, Adriaanse MC. --to: M. Koopmanschap: Coping with Type 2 diabetes: the patient's perspective. Diabetologia 45:S18-S22. Diabetologia 2003; 46:302-3. [PMID: 12627334 DOI: 10.1007/s00125-002-1023-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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