Screening for and subsequent participation in a trial for depression and anxiety in people with type 2 diabetes treated in primary care: Who do we reach?
SourcePrimary Care Diabetes, 11, 3, (2017), pp. 273-280
Article / Letter to editor
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Primary Care Diabetes
SubjectRadboudumc 5: Inflammatory diseases RIHS: Radboud Institute for Health Sciences
AIMS: This study investigated (factors related to) (a) the response to a screening procedure for depression and anxiety in people with type 2 diabetes in primary care, and (b) participation in a subsequent randomised controlled trial targeting depressive or anxiety symptoms. METHODS: People with type 2 diabetes (n=1837) received a screening questionnaire assessing depressive symptoms (PHQ-9) and anxiety symptoms (GAD-7). Eligible persons who scored above the cut-off score (PHQ-9>/=7 or GAD-7>/=8) were offered to participate in the trial. RESULTS: In total, 798 people (43%) returned the screening questionnaire. Non-responders were more often female (53% vs 44%, p<0.001), had higher LDL cholesterol levels (Cohen's d=0.17, p=0.001) and a higher albumin/creatinine ratio (Cohen's d=0.08, p=0.01). In total, 130 people (18%) reported elevated depressive or anxiety symptoms. Twenty-seven persons agreed to participate in the trial. Factors related to participation were a high education level, a higher level of diabetes distress and a history of psychological problems. CONCLUSIONS: Using screening as recruitment resulted in a small number of participants in a treatment trial for anxiety and depression. Research is needed to investigate whether screening is also followed by a low uptake of treatment in primary care outside a RCT setting.
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