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dc.contributor.authorGonzalez, Jeffrey S.
dc.contributor.authorPeyrot, Mark
dc.contributor.authorMcCarl, Lauren
dc.contributor.authorCollins, Erin Marie
dc.contributor.authorSerpa, Luis
dc.contributor.authorMimiaga, Matthew James
dc.contributor.authorSafren, Steven Alex
dc.date.accessioned2010-12-10T15:27:44Z
dc.date.issued2008
dc.identifier.citationGonzalez, Jeffrey S., Mark Peyrot, Lauren A. McCarl, Erin Marie Collins, Luis Serpa, Matthew J. Mimiaga, and Steven A. Safren. 2008. Depression and diabetes treatment nonadherence: a meta-analysis. Diabetes Care 31(12): 2398-2403.en_US
dc.identifier.issn0149-5992en_US
dc.identifier.urihttp://nrs.harvard.edu/urn-3:HUL.InstRepos:4622121
dc.description.abstractOBJECTIVE—Depression is common in patients with diabetes and is associated with worse treatment outcomes. Its relationship to treatment adherence, however, has not been systematically reviewed. We used meta-analysis to examine the relationship between depression and treatment nonadherence in patients with type 1 and type 2 diabetes. RESEARCH DESIGN AND METHODS—We searched MEDLINE and PsycINFO databases for all studies published by June 2007 and reviewed references of published articles. Meta-analytic procedures were used to estimate the effect size r in a random effects model. Significance values, weighted effect sizes, 95% CIs, and tests of homogeneity of variance were calculated. RESULTS—Results from 47 independent samples showed that depression was significantly associated with nonadherence to the diabetes treatment regimen (z = 9.97, P < 0.0001). The weighted effect size was near the medium range (r = 0.21, 95% CI 0.17–0.25). Moderator analyses showed that the effect was significantly larger in studies that measured self-care as a continuous versus categorical variable (P = 0.001). Effect sizes were largest for missed medical appointments and composite measures of self-care (r values = 0.31, 0.29). Moderation analyses suggest that effects for most other types of self-care are also near the medium range, especially in studies with stronger methodologies. CONCLUSIONS—These findings demonstrate a significant association between depression and treatment nonadherence in patients with diabetes. Studies that used stronger methodologies had larger effects. Treatment nonadherence may represent an important pathway between depression and worse diabetes clinical outcomes.en_US
dc.language.isoen_USen_US
dc.publisherAmerican Diabetes Associationen_US
dc.relation.isversionofdoi:10.2337/dc08-1341en_US
dc.relation.hasversionhttp://www.ncbi.nlm.nih.gov/pmc/articles/PMC2584202/pdf/en_US
dash.licenseLAA
dc.titleDepression and Diabetes Treatment Nonadherence: A Meta-Analysisen_US
dc.typeJournal Articleen_US
dc.description.versionVersion of Recorden_US
dc.relation.journalDiabetes Careen_US
dash.depositing.authorSafren, Steven Alex
dc.date.available2010-12-10T15:27:44Z
dash.affiliation.otherHMS^Psychiatry-Massachusetts General Hospitalen_US
dash.affiliation.otherHMS^Psychiatry-Massachusetts General Hospitalen_US
dc.identifier.doi10.2337/dc08-1341*
dash.contributor.affiliatedMcCarl, Lauren
dash.contributor.affiliatedMimiaga, Matthew J.
dash.contributor.affiliatedSafren, Steven A.


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