124043 20240731103319.0 doi 10.3390/ijerph20010328 sideral 132664 ART-2023-132664 eng Lozano del Hoyo, María Luisa, Universidad de Zaragoza (orcid)0000-0003-2448-1630 The TELE-DD randomised controlled trial on treatment adherence in patients with type 2 diabetes and comorbid depression: clinical outcomes after 18-month follow-up 2023 Access copy available to the general public Unrestricted Clinical depression is associated with poorer adherence to hypoglycaemic medication in patients with diabetes mellitus, leading to poorer glycaemic control, diabetes management, and increased complications. The main aim of the TELE-DD trial was to demonstrate the efficacy of a proactive and psychoeducational telephonic intervention based on motivational interviewing and collaborative care to reduce nonadherence and improve prognosis in individuals with diabetes mellitus and concurrent depression. Design: The TELE-DD project is a three-phased prospective study including a nested randomised controlled trial. Methods: The baseline cohort included the entire population of adult patients diagnosed with type 2 diabetes and concurrent depression. A randomised controlled trial was conducted in a selection of patients from the baseline cohort, distributed into a control group (n = 192) and an intervention group (n = 192). Monthly telephonic interventions delivered by specifically trained research nurses were centred on a psychoeducational individualised monitoring protocol including motivational interviewing and collaborative care strategies. Clinical and patient-centred data were systematically collected during an 18-month follow-up including HbA1c, Patient Health Questionnaire, and the Diabetes Distress Scale. Results: During the trial, 18-month follow-up HbA1C levels significantly (p < 0.001) decreased in the intervention group at every follow-up from an average of 8.72 (SD:1.49) to 7.03 (SD:1.09), but slightly increased in the control group from 8.65 (SD:1.40) to 8.84 (SD:1.38). Similar positive results were obtained in depression severity and diabetes distress, LDL-cholesterol, and systolic and diastolic blood pressure, but only at the 18-month follow-up in body mass index reduction. Conclusions: This is the first trial to concurrently decrease biological and psychological outcomes with a monthly brief telephonic intervention, pointing out that a combined biopsychosocial intervention and collaborative care strategy is essential for current world health challenges. ClinicalTrials.gov Identifier: NCT04097483. Patient or Public Contribution: Diabetic patients not belonging to the TELE-DD population or trial sample were consulted during the study design to review and guarantee the clarity and understanding of the trial psychoeducational materials. info:eu-repo/grantAgreement/ES/DGA/B43-20R Grupo Agua y salud info:eu-repo/grantAgreement/ES/ISCIII-MECD-IISZ/FI17-00180 info:eu-repo/semantics/openAccess by http://creativecommons.org/licenses/by/3.0/es/ 0.808 2023 Health, Toxicology and Mutagenesis 2023 Q2 Public Health, Environmental and Occupational Health 2023 Q2 Pollution 2023 Q2 7.3 2023 info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion Fernández Rodrigo, María Teresa Universidad de Zaragoza (orcid)0000-0002-6455-119X Urcola Pardo, Fernando Universidad de Zaragoza (orcid)0000-0001-7049-8295 Monreal Bartolomé, Alicia Universidad de Zaragoza (orcid)0000-0003-2088-2007 Gracia Ruiz, Diana Cecilia Gómez Borao, Mercedes Universidad de Zaragoza Alcázar Artigas, Ana Belén Martínez Casbas, José Pedro Universidad de Zaragoza Aceituno Casas, Alexandra Andaluz Funcia, María Teresa Roy Delgado, Juan Francisco Universidad de Zaragoza (orcid)0000-0003-4013-1315 1006 255 Universidad de Zaragoza Dpto. Fisiatría y Enfermería Área Enfermería 4009 735 Universidad de Zaragoza Dpto. Psicología y Sociología Área Psicolog.Evolut.Educac 20, 1 (2023), 328 [18 pp] Int. j. environ. res. public health International journal of environmental research and public health 1661-7827 1461003 http://zaguan.unizar.es/record/124043/files/texto_completo.pdf Versión publicada 2845757 http://zaguan.unizar.es/record/124043/files/texto_completo.jpg?subformat=icon icon Versión publicada oai:zaguan.unizar.es:124043 articulos driver 2024-07-31-09:42:25 ARTICLE