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首页> 外文期刊>Diabetes care >Randomized Trial of a Tailored Cognitive Behavioral Intervention in Type 2 Diabetes With Comorbid Depressive and/or Regimen-Related Distress Symptoms: 12-Month Outcomes From COMRADE
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Randomized Trial of a Tailored Cognitive Behavioral Intervention in Type 2 Diabetes With Comorbid Depressive and/or Regimen-Related Distress Symptoms: 12-Month Outcomes From COMRADE

机译：随机试验在2型糖尿病中定制的认知行为干预，具有共用抑郁和/或方案相关的痛苦症状：来自同志的12个月成果

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摘要

OBJECTIVE This study evaluated the effect of cognitive behavioral therapy (CBT) plus lifestyle counseling in primary care on hemoglobin A(1c) (HbA(1c)) in rural adult patients with type 2 diabetes (T2D) and comorbid depressive or regimen-related distress (RRD) symptoms. RESEARCH DESIGN AND METHODS This study was a randomized controlled trial of a 16-session severity-tailored CBT plus lifestyle counseling intervention compared with usual care. Outcomes included changes in HbA(1c), RRD, depressive symptoms, self-care behaviors, and medication adherence across 12 months. RESULTS Patients included 139 diverse, rural adults (mean age 52.6 +/- 9.5 years; 72% black; BMI 37.0 +/- 9.0 kg/m(2)) with T2D (mean HbA(1c) 9.6% [81 mmol/mol] +/- 2.0%) and comorbid depressive or distress symptoms. Using intent-to-treat analyses, patients in the intervention experienced marginally significant improvements in HbA(1c) (-0.92 +/- 1.81 vs. -0.31 +/- 2.04; P = 0.06) compared with usual care. However, intervention patients experienced significantly greater improvements in RRD (-1.12 +/- 1.05 vs. -0.31 +/- 1.22; P = 0.001), depressive symptoms (-3.39 +/- 5.00 vs. -0.90 +/- 6.17; P = 0.01), self-care behaviors (1.10 +/- 1.30 vs. 0.58 +/- 1.45; P = 0.03), and medication adherence (1.00 +/- 2.0 vs. 0.17 +/- 1.0; P = 0.02) versus usual care. Improvement in HbA(1c) correlated with improvement in RRD (r = 0.3; P = 0.0001) and adherence (r = -0.23; P = 0.007). CONCLUSIONS Tailored CBT with lifestyle counseling improves behavioral outcomes and may improve HbA(1c) in rural patients with T2D and comorbid depressive and/or RRD symptoms.
机译：目的本研究评估了认知行为治疗（CBT）加上初级护理的血红蛋白A（1C）（HBA（1C））对2型糖尿病（T2D）和共同抑郁症或方案相关窘迫的血红蛋白A（1C））对初级保健的影响（RRD）症状。研究设计和方法本研究是一项随机对照试验，对16届严重程度定制的CBT加上生活方式咨询干预的随机对照试验。结果包括HBA（1C），RRD，抑郁症状，自我保健行为和12个月内药物依从性的变化。结果患者包括139种不同的农村成人（平均52.6 +/- 9.5岁; 72％黑色; BMI 37.0 +/- 9.0 kg / m（2）），具有T2D（平均HBA（1c）9.6％[81 mmol / mol ] +/- 2.0％）和合并抑郁或痛苦症状。与通常的护理相比，使用意图对治疗分析，干预患者在HBA（1C）（-0.92 +/- 1.81和-0.31 +/- 2.04; p = 0.06）中经历了略微显着的改善。然而，干预患者在RRD中经历了更大的改善（-1.12 +/- 1.05与-0.31 +/- 1.22; p = 0.001），抑郁症状（-3.39 +/- 5.00与-0.90 +/- 6.17; p = 0.01），自我护理行为（1.10 +/- 1.30与0.58 +/- 1.45; p = 0.03），药物遵守（1.00 +/- 2.0与0.17 +/- 1.0; p = 0.02）与常见关心。 HBA（1c）的改善与RRD的改善相关（r = 0.3; p = 0.0001）和粘附（r = -0.23; p = 0.007）。结论量身定制的CBT与生活方式咨询提高了行为结果，可改善T2D和合并抑郁和/或RRD症状的农村患者中的HBA（1C）。

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  • 来源
    《Diabetes care》 |2019年第5期|共8页
  • 作者

    Cummings Doyle M.; Lutes Lesley D.; Littlewood Kerry; Solar Chelsey; Carraway Marissa; Kirian Kari; Patil Shivajirao; Adams Alyssa; Ciszewski Stefanie; Edwards Sheila; Gatlin Peggy; Hambidge Bertha;

  • 作者单位

    East Carolina Univ Brody Sch Med Dept Family Med Greenville NC 27858 USA;

    Univ British Columbia Dept Psychol Kelowna BC Canada;

    Univ S Florida Sch Social Work Tampa FL USA;

    East Carolina Univ Dept Psychol Greenville NC 27858 USA;

    East Carolina Univ Brody Sch Med Dept Family Med Greenville NC 27858 USA;

    East Carolina Univ Brody Sch Med Dept Family Med Greenville NC 27858 USA;

    East Carolina Univ Brody Sch Med Dept Family Med Greenville NC 27858 USA;

    East Carolina Univ Brody Sch Med Dept Family Med Greenville NC 27858 USA;

    Univ British Columbia Dept Psychol Kelowna BC Canada;

    East Carolina Univ Brody Sch Med Dept Family Med Greenville NC 27858 USA;

    East Carolina Univ Brody Sch Med Dept Family Med Greenville NC 27858 USA;

    East Carolina Univ Brody Sch Med Dept Family Med Greenville NC 27858 USA;

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  • 正文语种 eng
  • 中图分类 内分泌腺疾病及代谢病;
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