Evidence map›Paper›PMID 18332158›Full record

Trial reportDiabetes care2008

Long-term effects on medical costs of improving depression outcomes in patients with depression and diabetes.

Wayne J Katon, Joan E Russo, Michael Von Korff, Elizabeth H B Lin, Evette Ludman, Paul S Ciechanowski

Open access · bronzeAbstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Diabetes care, 2008. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 63 papers, 5 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
63citing papers in PubMed, 5 pooled it
8.5field-weighted citation impact, top 2% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

63 citing papers in PubMed, 5 syntheses or guidelines pooled it, 172 citations in OpenAlex.

  1. Pooled it
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  4. Collaborative care for depression and anxiety problems.The Cochrane database of systematic reviews · 2012
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  16. Cost-effectiveness analysis of collaborative care management of major depression among low-income, predominantly Hispanics with diabetes.Value in health : the journal of the International Society for Pharmacoeconomics and Outcomes Research
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  18. Article
  19. Article
  20. Integrating mental health and non-communicable disease care: A WONCA advocacy project report.African journal of primary health care & family medicine · 2025
    Article

3 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 3 institutions in 1 country.

Wayne J KatonDepartment of Psychiatry, University of Washington School of Medicine, Seattle, Washington 98195-6560, USA. wkaton@u.washington.edu
Joan E Russo
Michael Von Korff
Elizabeth H B Lin
Evette Ludman
Paul S Ciechanowski
University of Washington · USGroup Health Cooperative · USUniversity of Puget Sound · US

Funding

RANDOMIZED TRIAL OF LIAISON PSYCHIATRY IN PRIMARY CARER01MH041739 · NIMH · UNIVERSITY OF WASHINGTON · PI KATON, WAYNE J · 1987 to 2010
$6.6M
Population-Based Psychiatric Intervention--Primary CareK24MH069471 · NIMH · UNIVERSITY OF WASHINGTON · PI KATON, WAYNE J · 2004 to 2011
$1.0M
Quality Improvement of School Mental Health ServicesK08MH069741 · NIMH · UNIVERSITY OF CALIFORNIA LOS ANGELES · PI KATAOKA, SHERYL H · 2004 to 2008
$769k
NIMH NIH HHS K08 MH069741NIMH NIH HHS K24 MH069471NIMH NIH HHS K24 MH069741NIMH NIH HHS MH41739NIMH NIH HHS R01 MH041739
6 · The paper itself

Abstract

objectiveThe purpose of this study was to examine the 5-year effects on total health care costs of the Pathways depression intervention program for patients with diabetes and comorbid depression compared with usual primary care. RESEARCH DESIGN AND

methodsThe Pathways Study was conducted in nine primary care practices of a large HMO and enrolled 329 patients with diabetes and comorbid major depression. The current study analyzed the differences in long-term medical costs between intervention and usual care patients. Participants were randomly assigned to a nurse depression intervention (n = 164) or to usual primary care (n = 165). The intervention included education about depression, behavioral activation, and a choice of either starting with support of antidepressant medication treatment by the primary care doctor or problem-solving therapy in primary care. Interventions were provided for up to 12 months, and the main outcome measures are health costs over a 5-year period.

resultsPatients in the intervention arm of the study had improved depression outcomes and trends for reduced 5-year mean total medical costs of -$3,907 (95% CI -$15,454 less to $7,640 more) compared with usual care patients. A sensitivity analysis found that these cost differences were largely explained by the patients with depression and the most severe medical comorbidity.

conclusionsThe Pathways depression collaborative care program improved depression outcomes compared with usual care with no evidence of greater long-term costs and with trends for reduced costs among the more severely medically ill patients with diabetes.

Indexed as

AdultAgedAntidepressive AgentsCost of IllnessDepressive DisorderDiabetes ComplicationsEmploymentFemaleHumansMaleMarital StatusMiddle AgedPatient Education as TopicRacial GroupsSocial SupportSurveys and QuestionnairesAntidepressive Agents

Identifiers

PMID18332158
PMCPMC3810023
OpenAlexW2169336972

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.