ArticleBMJ open2013
The TrueBlue model of collaborative care using practice nurses as case managers for depression alongside diabetes or heart disease: a randomised trial.
Article in BMJ open, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 61 papers, 17 of them syntheses that pooled it.
What it found
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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.
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.
Who cites it
61 citing papers in PubMed, 17 syntheses or guidelines pooled it, 124 citations in OpenAlex.
- Effects of Integrated Care Approaches to Address Co-occurring Depression and Diabetes: A Systematic Review and Meta-analysis.Diabetes care · 2024Pooled it
- Psychological interventions for depression and anxiety in patients with coronary heart disease, heart failure or atrial fibrillation.The Cochrane database of systematic reviews · 2024Pooled it
- Interprofessional collaboration in primary care: what effect on patient health? A systematic literature review.BMC primary care · 2023Pooled it
- Quality improvement strategies for diabetes care: Effects on outcomes for adults living with diabetes.The Cochrane database of systematic reviews · 2023Pooled it
- Primary care team and its association with quality of care for people with multimorbidity: a systematic review.BMC primary care · 2023Pooled it
- Case management interventions in chronic disease reduce anxiety and depressive symptoms: A systematic review and meta-analysis.PloS one · 2023Pooled it
- Specific content for collaborative care: a systematic review of collaborative care interventions for patients with multimorbidity involving depression and/or anxiety in primary care.Family practice · 2022Pooled it
- Pooled it
- Pooled it
- Interventions for improving outcomes in patients with multimorbidity in primary care and community settings.The Cochrane database of systematic reviews · 2021Pooled it
- Underlying mechanisms of complex interventions addressing the care of older adults with multimorbidity: a realist review.BMJ open · 2019Pooled it
- Helping patients help themselves: A systematic review of self-management support strategies in primary health care practice.PloS one · 2019Pooled it
- Effectiveness of interventions for managing multiple high-burden chronic diseases in older adults: a systematic review and meta-analysis.CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne · 2018Pooled it
- A systematic review of care management interventions targeting multimorbidity and high care utilization.BMC health services research · 2018Pooled it
- Interventions for improving outcomes in patients with multimorbidity in primary care and community settings.The Cochrane database of systematic reviews · 2016Pooled it
- Pooled it
- Collaborative care for comorbid depression and diabetes: a systematic review and meta-analysis.BMJ open · 2014Pooled it
- Participatory care plan for primary care patients with long-term diseases: results after a 36-month follow-up of a randomized controlled trial.BMC health services research · 2025Trial
- Randomized controlled study of the impact of a participatory patient care plan among primary care patients with common chronic diseases: a one-year follow-up study.BMC health services research · 2021Trial
- Improving Physical Health in Patients With Chronic Mental Disorders: Twelve-Month Results From a Randomized Controlled Collaborative Care Trial.The Journal of clinical psychiatry · 2017Trial
1 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesTo determine the effectiveness of collaborative care in reducing depression in primary care patients with diabetes or heart disease using practice nurses as case managers.
designA two-arm open randomised cluster trial with wait-list control for 6 months. The intervention was followed over 12 months.
settingEleven Australian general practices, five randomly allocated to the intervention and six to the control.
participants400 primary care patients (206 intervention, 194 control) with depression and type 2 diabetes, coronary heart disease or both.
interventionThe practice nurse acted as a case manager identifying depression, reviewing pathology results, lifestyle risk factors and patient goals and priorities. Usual care continued in the controls.
main outcome measureA five-point reduction in depression scores for patients with moderate-to-severe depression. Secondary outcome was improvements in physiological measures.
resultsMean depression scores after 6 months of intervention for patients with moderate-to-severe depression decreased by 5.7±1.3 compared with 4.3±1.2 in control, a significant (p=0.012) difference. (The plus-minus is the 95% confidence range.) Intervention practices demonstrated adherence to treatment guidelines and intensification of treatment for depression, where exercise increased by 19%, referrals to exercise programmes by 16%, referrals to mental health workers (MHWs) by 7% and visits to MHWs by 17%. Control-practice exercise did not change, whereas referrals to exercise programmes dropped by 5% and visits to MHWs by 3%. Only referrals to MHW increased by 12%. Intervention improvements were sustained over 12 months, with a significant (p=0.015) decrease in 10-year cardiovascular disease risk from 27.4±3.4% to 24.8±3.8%. A review of patients indicated that the study's safety protocols were followed.
conclusionsTrueBlue participants showed significantly improved depression and treatment intensification, sustained over 12 months of intervention and reduced 10-year cardiovascular disease risk. Collaborative care using practice nurses appears to be an effective primary care intervention.
trial registrationACTRN12609000333213 (Australia and New Zealand Clinical Trials Registry).
Identifiers
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Registered trials
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.