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APHA Scientific Session and Event Listing

Wenhui Wei, PhD¹, Leonard Pogach, MD, PhD², and Usha Sambamoorthi, PhD². (1) Department of Veterans Affairs, NJ Health Care System, Center for Healthcare Knowledge Management, 385 Tremont Avenue, East Orange, NJ 07018, (2) Center for Healthcare Knowledge Management, Department of Veterans Affairs, NJ Health Care System, 385 Tremont avenue, East Orange, NJ 07018, 973-676-1000 x1512, ushasambamoorthi@gmail.com

OBJECTIVE: Diabetes and depression are both common chronic diseases and depression treatment has been shown to improve health outcomes; however, studies that address patterns of depression treatment in patients with diabetes are scarce. Our objective was to estimate depression treatment rates among individuals with diabetes and examine its association with patient-level factors. DESIGN: Data are from multiple years (2000-2003) of the nationally representative data, the Medical Expenditure Panel Survey (MEPS). Depression (ICD9-CM codes 296, 311) and diabetes (250) were identified using medical conditions files. Antidepressant medications were identified using national drug codes from pharmacy files. Psychotherapy visits were identified from both outpatient and office-based medical visit files. Chi-square tests and ordered logistic regression analysis were used to predict depression treatment among diabetes patients, adjusting for the complex survey design of MEPS data. POPULATION: The study population included 6,327 individuals aged over 21 years with diabetes in calendar years 2000 through 2003 and alive as of the end of the calendar year. FINDINGS: Overall, 12% (N = 777) of individuals with diabetes had comorbid depression. Of these, 33% received no treatment for depression; 7% only psychotherapy; 46% only antidepressants and 14% both. Those who were not on diabetes medications were 3 times as likely to be treated for depression as those with insulin and oral medications, after controlling for differences in demographic, socioeconomic and health status. CONCLUSION: Some patients with diabetes may have avoided pharmacological treatment of depression due to concerns of potentially negative impact of tricyclic antidepressants on glycemic control.

Learning Objectives:

• At the end of the session the participants will learn about a) How to identify diabetes and depression from ICD-9 codes; b) Treatment among individuals with comorbid chronic conditions and
• c) How one treatment for one condition affects the treatment for the other.

Keywords: Diabetes, Depression

Presenting author's disclosure statement:

Not Answered