Research ArticleOriginal Research

Integration of Depression and Hypertension Treatment: A Pilot, Randomized Controlled Trial

Hillary R. Bogner and Heather F. de Vries
The Annals of Family Medicine July 2008, 6 (4) 295-301; DOI: https://doi.org/10.1370/afm.843

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Tables

  • Table 1.

    Sample Characteristics at Baseline

    CharacteristicUsual Care (n=32)Intervention (n=32)PValue
    CES-D = Center for Epidemiologic Studies Depression Scale; MMSE = Mini-Mental State Examination; SF-36 = Medical Outcomes Study Short Form.
    Note: P values represent comparisons according to Fisher’s exact test and t tests for categorical or continuous data, respectively.
    Sociodemographic characteristics
        Age, mean y (SD)57.5 (6.3)59.7 (7.3).20
        Ethnicity, African American, n (%)28 (87.5)25 (78.1).35
        Sex, women, n (%)25 (78.1)24 (75.0).50
        Less than high school education, n (%)9 (28.1)6 (18.8).28
        Lives alone, n (%)10 (31.3)15 (46.9).15
    SF-36 scores
        Physical function score, mean (SD)64.5 (34.9)54.1 (33.2).22
        Social function score, mean (SD)83.8 (33.5)75.6 (37.6).37
        Role physical score, mean (SD)65.6 (42.5)55.5 (42.0).34
        Role emotional score, mean (SD )74.0 (43.0)63.5 (46.7).36
        Bodily pain score, mean (SD)60.6 (35.7)46.3 (33.1).10
    Other covariates
        MMSE, mean (SD)27.9 (3.2)27.7 (2.7).73
        Number of medications, n (SD)7.0 (3.6)8.6 (5.1).16
    Outcome measures
        CES-D, mean (SD)19.6 (14.2)17.5 (13.2).54
        Systolic blood pressure, mean (SD), mm Hg143.1 (22.5)146.7 (20.9).51
        Diastolic blood pressure, mean (SD), mm Hg81.4 (11.1)83.0 (10.7).58
        ≥ 80% adherent to antidepressant, n (%)16 (50.0)14 (43.0).81
        ≥ 80% adherent to antihypertensive, n (%)11 (34.4)16 (50.0).31
  • Table 2.

    Depression Symptoms, Blood Pressure, and Adherence to Antidepressant and Antihypertensive Medications of Participants in Usual Care and in the Integrated Intervention at 6 Weeks

    VariableUsual Care (n=32)Intervention (n=32)PValue
    CES-D = Center for Epidemiologic Studies Depression Scale.
    Note: P values represent statistical tests using t tests for continuous measures and Fisher’s exact test for categorical variables.
    CES-D, mean (SD), score19.3 (15.2)9.9 (10.7).006
    Systolic blood pressure, mean (SD), mm Hg141.3 (18.8)127.3 (17.7).003
    Diastolic blood pressure, mean (SD), mm Hg85.0 (11.9)75.8 (10.7).002
    ≥ 80% adherent to antidepressant, n (%)10 (31.3)23 (71.9).001
    ≥ 80% adherent to antihypertensive, n (%)10 (31.3)25 (78.1)<.001

Additional Files

  • In Brief

    Integration of Depression and Hypertension Treatment: A Pilot, Randomized Controlled Trial

    Hillary R. Bogner , and colleagues

    Background Past research suggests the importance of coordinating the management of depression with management of other medical conditions, especially cardiovascular disease. An integrated approach to care might also be more acceptable to patients than managing depression alone. In this study, researchers examine whether a single program to treat depression and care for high blood pressure improves older patients' depression symptoms, blood pressure control, and willingness to take depression and blood pressure medications.

    What This Study Found Compared with other patients, primary care patients who receive an integrated approach to care have lower blood pressure and fewer depressive symptoms, and they take their depression and blood pressure medications at higher rates.

    Implications

    • Integrated programs may be especially valuable in medical practices where there are competing demands for limited resources.
    • Further research is needed to evaluate an integrated care approach in a larger sample of patients with longer periods of follow-up.
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