Lisa G Rosas1, Kristen M J Azar2, Nan Lv3, Lan Xiao4, Jeremy D Goldhaber-Fiebert4, Mark B Snowden5, Elizabeth M Venditti6, Megan M Lewis7, Andrea N Goldstein-Piekarski8, Jun Ma9. 1. Department of Epidemiology and Population Health, Stanford University, Palo Alto, California; Department of Medicine, Stanford University, Palo Alto, California. 2. Sutter Health Research, Sutter Health, Palo Alto, California. 3. Department of Medicine and Institute of Health Research and Policy, University of Illinois at Chicago, Chicago, Illinois. 4. Department of Epidemiology and Population Health, Stanford University, Palo Alto, California. 5. Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, Washington. 6. Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania. 7. Center for Communications Science, RTI International, Seattle, Washington. 8. Department of Psychiatry and Behavioral Sciences, Stanford University, Palo Alto, California. 9. Department of Medicine and Institute of Health Research and Policy, University of Illinois at Chicago, Chicago, Illinois. Electronic address: maj2015@uic.edu.
Abstract
INTRODUCTION: An integrated collaborative care intervention was successful for treating comorbid obesity and depression. The effect of the integrated intervention on secondary outcomes of quality of life and psychosocial functioning were examined, as well as whether improvements in these secondary outcomes were correlated with improvements in the primary outcomes of weight and depressive symptoms. STUDY DESIGN: This RCT compared an integrated collaborative care intervention for obesity and depression to usual care. Data were analyzed in 2018. SETTING/PARTICIPANTS: Adult primary care patients (n=409) with a BMI ≥30 (≥27 if Asian) and 9-Item Patient Health Questionnaire score ≥10 were recruited from September 30, 2014 to January 12, 2017 from primary care clinics in Northern California. INTERVENTION: The 12-month intervention integrated a behavioral weight loss program and problem-solving therapy with as-needed antidepressant medications for depression. MAIN OUTCOME MEASURES: A priori secondary outcomes included health-related quality of life (Short Form-8 Health Survey), obesity-specific quality of life (Obesity-Related Problems Scale), sleep disturbance and sleep-related impairment (Patient-Reported Outcomes Measurement Information System), and functional disability (Sheehan Disability Scale) at baseline and 6 and 12 months. RESULTS: Participants randomized to the intervention experienced significantly greater improvements in obesity-specific problems, mental health-related quality of life, sleep disturbance, sleep-related impairment, and functional disability at 6 months but not 12 months. Improvements in obesity-related problems (β=0.01, 95% CI=0.01, 0.02) and sleep disturbance (β= -0.02, 95% CI= -0.04, 0) were associated with lower BMI. Improvements in the physical (β= -0.01, 95% CI= -0.01, 0) and mental health components (β= -0.02, 95% CI= -0.03, -0.02) of the Short Form-8 Health Survey as well as sleep disturbance (β=0.01, 95% CI=0.01, 0.02) and sleep-related impairment (β=0.01, 95% CI=0, 0.01) were associated with fewer depressive symptoms. CONCLUSIONS: An integrated collaborative care intervention for obesity and depression that was shown previously to improve weight and depressive symptoms may also confer benefits for quality of life and psychosocial functioning over 6 months. TRIAL REGISTRATION: This study is registered at clinicaltrials.gov NCT02246413.
RCT Entities:
INTRODUCTION: An integrated collaborative care intervention was successful for treating comorbid obesity and depression. The effect of the integrated intervention on secondary outcomes of quality of life and psychosocial functioning were examined, as well as whether improvements in these secondary outcomes were correlated with improvements in the primary outcomes of weight and depressive symptoms. STUDY DESIGN: This RCT compared an integrated collaborative care intervention for obesity and depression to usual care. Data were analyzed in 2018. SETTING/PARTICIPANTS: Adult primary care patients (n=409) with a BMI ≥30 (≥27 if Asian) and 9-Item Patient Health Questionnaire score ≥10 were recruited from September 30, 2014 to January 12, 2017 from primary care clinics in Northern California. INTERVENTION: The 12-month intervention integrated a behavioral weight loss program and problem-solving therapy with as-needed antidepressant medications for depression. MAIN OUTCOME MEASURES: A priori secondary outcomes included health-related quality of life (Short Form-8 Health Survey), obesity-specific quality of life (Obesity-Related Problems Scale), sleep disturbance and sleep-related impairment (Patient-Reported Outcomes Measurement Information System), and functional disability (Sheehan Disability Scale) at baseline and 6 and 12 months. RESULTS:Participants randomized to the intervention experienced significantly greater improvements in obesity-specific problems, mental health-related quality of life, sleep disturbance, sleep-related impairment, and functional disability at 6 months but not 12 months. Improvements in obesity-related problems (β=0.01, 95% CI=0.01, 0.02) and sleep disturbance (β= -0.02, 95% CI= -0.04, 0) were associated with lower BMI. Improvements in the physical (β= -0.01, 95% CI= -0.01, 0) and mental health components (β= -0.02, 95% CI= -0.03, -0.02) of the Short Form-8 Health Survey as well as sleep disturbance (β=0.01, 95% CI=0.01, 0.02) and sleep-related impairment (β=0.01, 95% CI=0, 0.01) were associated with fewer depressive symptoms. CONCLUSIONS: An integrated collaborative care intervention for obesity and depression that was shown previously to improve weight and depressive symptoms may also confer benefits for quality of life and psychosocial functioning over 6 months. TRIAL REGISTRATION: This study is registered at clinicaltrials.gov NCT02246413.
Authors: Jun Ma; Lisa Goldman Rosas; Nan Lv; Lan Xiao; Mark B Snowden; Elizabeth M Venditti; Megan A Lewis; Jeremy D Goldhaber-Fiebert; Philip W Lavori Journal: JAMA Date: 2019-03-05 Impact factor: 56.272
Authors: Susan J Curry; Alex H Krist; Douglas K Owens; Michael J Barry; Aaron B Caughey; Karina W Davidson; Chyke A Doubeni; John W Epling; David C Grossman; Alex R Kemper; Martha Kubik; C Seth Landefeld; Carol M Mangione; Maureen G Phipps; Michael Silverstein; Melissa A Simon; Chien-Wen Tseng; John B Wong Journal: JAMA Date: 2018-09-18 Impact factor: 56.272
Authors: Jun Ma; Veronica Yank; Nan Lv; Jeremy D Goldhaber-Fiebert; Megan A Lewis; M Kaye Kramer; Mark B Snowden; Lisa G Rosas; Lan Xiao; Andrea C Blonstein Journal: Contemp Clin Trials Date: 2015-06-19 Impact factor: 2.226
Authors: Jun Ma; Veronica Yank; Lan Xiao; Philip W Lavori; Sandra R Wilson; Lisa G Rosas; Randall S Stafford Journal: JAMA Intern Med Date: 2013-01-28 Impact factor: 21.873
Authors: Jessica L Unick; Rebecca H Neiberg; Patricia E Hogan; Lawrence J Cheskin; Gareth R Dutton; Robert Jeffery; Julie A Nelson; Xavier Pi-Sunyer; Delia Smith West; Rena R Wing Journal: Obesity (Silver Spring) Date: 2015-07 Impact factor: 5.002
Authors: Elizabeth M Venditti; Lesley E Steinman; Megan A Lewis; Bryan J Weiner; Jun Ma Journal: Transl Behav Med Date: 2021-09-15 Impact factor: 3.046