Disease Management Update
Volume IV, No. 33
December 13, 2007

Dear Healthcare Intelligence Network Client,

This year alone, more than 17 million American adults were affected with some type of depression, and approximately 20 percent of the U.S. population reports at least one depressive symptom in a given month.

This week's Disease Management Update takes a look at how depression is related to other diseases like diabetes and Parkinson's disease. And HIN's blog features a study linking a state's treatment access to the mental well-being of its residents.

Your colleague in the business of healthcare,
Laura M. Greene
Editor, Disease Management Update

If this is a forwarded copy of Disease Management Update and you like what you see, you can register to receive your own copy of this complimentary service. Sign up at:
http://www.hin.com/dmdesktop/diseasemanagement.html

Table of Contents

  1. Relatives of Patients with Parkinson's Disease Face Increased Risk of Depression and Anxiety Disorders
  2. Disease Management Q&A: Getting Resistant Members to Comply with DM
  3. HealthSounds Podcast: A Positive Psychology Approach to DM
  4. Treating Depression Prolongs Life for Older People with Diabetes
  5. Survey of the Month: Healthcare Consumerism
  6. Depression and Disease Management Identification and Treatment


1. Relatives of Patients with Parkinson's Disease Face Increased Risk of Depression and Anxiety Disorders

Immediate relatives (brother, sister, mother, father, son or daughter) of people who have Parkinson's disease are at increased risk for developing depression and anxiety disorders, according to a new study by Mayo Clinic. The risk is particularly increased in families of patients who develop Parkinson's disease before age 75.

For the study, the Mayo Clinic analyzed 1,000 immediate relatives of 162 patients with Parkinson's disease. The study showed that Parkinson's disease and psychiatric disorders may share familial factors that make a person susceptible to developing one or both. The familial susceptibility factors may be genetic, environmental or a combination of the two, and further research is needed to determine their exact nature.

"We found that, indeed, relatives of patients with Parkinson's disease are at increased risk for anxiety and depressive disorders, which suggests a genetic or other relationship between those disorders and Parkinson's disease," explains Walter Rocca, M.D., senior author of the study and a Mayo Clinic neurologist and epidemiologist.

To learn more about this study, please visit:
http://www.mayoclinic.org/news2007-rst/4364.html

2. Disease Management Q&A: Getting Resistant Members to Comply with DM

Each week, healthcare professionals respond to a reader's query on an industry issue. This week's expert is Dr. Sam Toney, manager of worksite health promotion for the Health Alliance Plan.

Question:How can we get resistant members to comply with psychotherapy for depression?

Answer: (Dr. Sam Toney) Not all individuals with depressive disorder meet criteria for psychotherapy. It’s a very important treatment intervention. Literature tells us that the most successful treatment interventions are dual modality interventions. Typical anti-depressant therapies, medication management and psychotherapy tend to produce the best results in combination.

You must assess an individual’s readiness and willingness to change. The qualification or clarification of appropriateness for psychotherapy is the first part of that equation. Determining that this patient meets criteria for psychotherapeutic intervention involves looking at the patient’s readiness to accept that intervention. Then we work with the patient through motivational interviewing and behavior change techniques provided by our clinicians to move that patient toward acceptance of that treatment modality.

It’s important to avoid employing psychotherapeutic interventions ourselves. This is sometimes a challenge for our clinicians, most of whom are psychotherapists, because there’s a temptation to enter into the therapeutic relationship. Thus, we have frequent in-house reminders that we render educational services to our care managers and that line cannot be crossed. We utilize certain techniques and interviewing skills to move our patients into acceptance of that modality.

For more details on depression and disease management, please visit:
http://store.hin.com/product.asp?itemid=3188

We want to hear from you! Submit your question for Disease Management Q&A to info@hin.com.

3. HealthSounds Podcast: A Positive Psychology Approach to DM

In this week's disease management podcast, Wellcoaches CEO Margaret Moore describes coaching theories and strategies and conducts a live coaching demonstration to illustrate the theories and strategies in action. She also weighs in with some suggestions for evaluating a health coach's performance.

To listen to this complimentary HIN podcast, please visit:
http://www.hin.com/podcasts/podcast.htm#41

4. Treating Depression Prolongs Life for Older People with Diabetes

Depressed, older adults with diabetes live longer when they are treated for depression, according to a study in the December issue of Diabetes Care. The depression study, which followed primary care patients in the New York City, Philadelphia and Pittsburgh areas for five years, also showed that treating depression reduced mortality more for those who had diabetes than for those who did not.

The results led researchers to conclude that better models of care should be developed that integrate depression management into the treatment of people with diabetes. Depressed people with diabetes who received more resources for depression treatment were half as likely to die over a five-year period compared to depressed people with diabetes who did not receive more resources for depression treatment.

“Depression is not only common in persons with diabetes but contributes to not taking medicines, not following prescribed diets, and overall reduced quality of life,” said lead researcher Dr. Hillary R. Bogner, assistant professor at the Department of Family Practice and Community Medicine at the University of Pennsylvania

To learn more about this study's findings, please visit:
http://www.diabetes.org/for-media/pr-treating-depression-prolongs-life-112707.jsp

5. Survey of the Month: Healthcare Consumerism

Complete our survey on healthcare consumerism efforts by December 31, and you'll get a free executive summary of the compiled results.

To participate in this survey and receive its results, please visit:
http://www.surveymonkey.com/s.aspx?sm=4aVEfWj3yq1yiPjHO407Ag_3d_3d

6. Depression and Disease Management Identification and Treatment

With the economic burden of depression and its co-morbidities estimated at $83 billion annually–hitting employers hardest in the form of lost workdays, compromised productivity and workplace accidents–the healthcare industry is formalizing programs for early identification, adequate treatment and medical adherence of individuals with depressive disorder. This is no small task, given the challenges of screening depression severity, overcoming the stigma of mental illness, and educating primary care physicians on the value of this initiative. In its August 2005 online survey, the Healthcare Intelligence Network (HIN) asked its audience for details on current and planned initiatives for depression and disease management.

To download this complimentary white paper, please visit:
http://www.hin.com/library/registerddm.html
Please forward this news announcement to your colleagues who might find it useful.
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