Older depressed patients with diabetes are significantly less likely to die over a five-year period if they receive depression-care management, according to a recent study (Diabetes Care 2007;30:3005-3010). It is believed to be the first investigation into the topic.

The researchers identified 123 depressed patients (mean age: 69 years) with diabetes in 20 primary-care practices from the New York, Philadelphia, and Pittsburgh metropolitan areas and randomized them to receive intervention (70 patients, or 57%) or their usual care (53 patients, or 43%).

In the intervention arm, trained depression-care managers offered guideline-based recommendations to the primary-care clinician and helped the patients with treatment adherence. Citalopram (Celexa) and psychotherapy were provided at no cost. In the usual-care practices, clinicians also received informational materials and treatment guidelines but no specific recommendations regarding individual patients.

After five years, the mortality rate was much higher among the usual-care patients: 103.4/1,000 person-years, compared with 68.2/1,000 person-years in the intervention group.

“We believe these findings support the integration of depression evaluation and treatment with diabetes management in primary care,” the investigators concluded.