The effectiveness of the depression care management programme on diabetic and hypertensive patients

Abstract

BACKGROUND: The prevalence of depressive symptoms among older adults in Hong Kong has reached an alarming figure. The current treatment to depressive older adults in Hong Kong causes the labelling effect leading to refrain from addressing the issue to their primary health practitioners or even family member. OBJECTIVE: This study aims to evaluate the effectiveness of the depression care management (DCM) programme on diabetic and hypertensive patients who regularly attend follow-up at Sai Wan Ho Health Centre. METHOD: Patients were invited to fill up a depressive assessment tool, Patient Health Questionnaire (PHQ9). Patients whose PHQ9 score were between 10 and 20 were recruited into the DCM programme. They received counselling from a trained depression care manager. Questionnaires were conducted to the subjects before the commencement of the service and 3 months after receiving the service. Their physical health and mental health were assessed by SF-12. The depression, anxiety and stress level were assessed by the short Depression Anxiety Stress Scales (DASS21) while the degree of social support was assessed by the Lubben Social Network Scale (LSNS). Paired t-tests were used to compare the mean differences of these variables. RESULTS: There are 43 participants in the programme. After receiving counselling, patients’ depression level (mean difference=-9.59, p<0.001) was significantly reduced. There is also a significant improvement in their mental health (mean difference=13.42, p<0.001) and the level of social support (mean difference=4.06, p=0.017). Their anxiety level (mean difference=-6.65, p<0.001) and stress level (mean difference=-9.94, p<0.001) were significantly reduced. DISCUSSION AND CONCLUSION: DCM programme seems to reduce diabetic and hypertensive patients’ depression, anxiety and stress level and improve their social network. A larger scale study with randomised design will be warranted to further investigate the effectiveness of depression care management service.