Suffering from diabetes or heart disease is challenging enough for patients to deal with and also for those physicians attempting to improve the situation. Patients often become extremely depressed as they deal with the new circumstances that are associated with these serious conditions. As a result, mentally and physically suffering persons increase health costs and make treatment significantly more inefficient.

Traditionally, physical ailments and mental depression have been treated separately and the results have been fragmented to say the least. However in a report this week published in the New England Journal of Medicine, it has been found that when a team of caretakers treat the onset of depression parallel to the attention to diabetes and heart disease in particular, the health of patients improves at a must faster rate than when these mental and physical problems are segmented and treated separately by different healthcare teams.

With team care, when nurses help doctors troubleshot potential rising conditions, the goal is to help cut the costs of treating complex patients which are estimated to be about $10,000 per year, according to study co-author Dr. Wayne Katon, a UW professor of psychiatry and behavioral sciences and an affiliate investigator at the Group Health Research Institute.

Researchers from the University of Washington and Group Health Cooperative in a report funded by the National Institute of Mental Health, tracked 214 Group Health patients with poorly controlled diabetes, coronary heart disease or both and also suffered from various levels of overall depression. The patients were randomly assigned to either traditional care or an approach in which nurse care managers coached them, monitored their disease control and depression and worked with their primary-care doctors. Each patient and the nurse care manager set goals to reduce depression, blood sugar, blood pressure and cholesterol.

The study found that in one year, patients receiving team care not only said they had better quality of life and greater satisfaction with their care, measurements showed they were less depressed and showed significant improvement in blood sugar, blood pressure and cholesterol levels.

Dr. Elizabeth Lin, one of the study’s authors, points out that however in a study conducted one year earlier, also by the University of Washington, did not show improvement in the tests related to diabetes and heart disease. The difference, Lin said, was that this study didn’t simply provide patients with attention from a provider, but helped them set and meet goals for improving their blood-sugar, blood-pressure and cholesterol measurements.

Lin continues:

“Without those specifics, and systematic ways, just providing additional attention or time doesn’t really work. We were very systematic about treating to target, meaning that when a patient didn’t meet a goal, the nurse manager helped troubleshoot.”

Researchers don’t yet know whether the interventions saved money, Lin said, but they expect based on previous work, that they will at least prove to be cost-neutral. In the future, researchers are hoping for savings when applied to large groups of patients.

Other studies show that patients with three or more chronic conditions, a group that includes more than 40 percent of Medicare beneficiaries, account for more than 80 percent of Medicare care costs.

Lin has recently received funding from the Group Health Foundation for a pilot program to translate this study to usual care in a selected Group Health clinic location. Group Health would roll out the team approach to other clinics if the study proves to cut costs and improve quality of life in patients with a combination of disorders.

The Partnership for Innovation, a $1.5 million donor supported initiative, will help realize Group Health’s vision of delivering affordable excellence for its patients by pilot-testing cost-effective approaches that have the potential to improve patient care.

Group Health medical teams on the front lines of patient care every day, are poised to identify new strategies to create healthier lives for patients. The Partnership for Innovation helps bring these ideas to life through the research expertise of the Group Health Research Institute, the daily efforts of clinical teams, and the generous funding of Foundation donors.

This powerful collaboration between care delivery, cutting-edge research, and philanthropy can provide answers to the big challenges in health care. Over the last three years, the Group Health Foundation received nearly 40 applications and awarded more than $1.3 million in grants to fund 14 innovative pilot projects, including $555,000 granted in 2010.

Dr. Lin finally concludes:

    “The problem isn’t just depression; it’s the patient who has co-existing conditions that’s becoming such a public-health challenge. This study is the culmination of the last 25 years of randomized studies to improve mental-health care in primary-care settings. We are extremely encouraged that (the patients) did better in terms of outcomes. I’m really excited about the direction we’re going.”

Written by Sy Kraft, B.A.