Depression in diabetes patients Cost-Effectiveness Analysis Research

Along with economic development, people's lifestyles change, an increasingly aging population. diabetes (mainly type II diabetes), the number is increasing rapidly. As a chronic metabolic disease, diabetes can lead to many complications caused great mental suffering to the patients. At the same time there are other risk factors, patients with depression were easy. Medical model to bio-psycho-social direction of the change is to improve symptoms and reduce the suffering of the disease and improve quality of life. the effect of rapidly rising health care costs increased demand. This paper reviews at home and abroad for the past 10 years the incidence of diabetes in patients with depression. In view of the heavy burden of diseases that the current cost-effectiveness analysis of the research results of antidepressant treatment. Despite the prevalence of diabetes in the race, the age difference Overall performance tended to rise on a global scale, especially in developing countries. Situation Fujian Normal University, Fuzhou 350007） popular show. China's rapid growth in the prevalence of diabetes, the prevalence rate has reached 3.21%[5-6] 1996. The United States took a 13-year longitudinal study has confirmed that the severe psychological repression and significantly associated with type II diabetes [7]. Kawakami and other Japanese electronics companies in the eight-year follow-up of 2,764 male staff. OU found that diabetic patients with depressive disorders susceptible. Talbot also found : Type I and Type II diabetes associated with changes in neurological and psychiatric depression relapse rate, longer duration, [10] and other serious symptoms. These results indicate that not only influence depression and diabetes, increased illness, but the two diseases were very common phenomenon. 1. Depression in diabetes patients of diabetes in high-risk patients with depression : the danger is not only higher than the general population. and the characteristics of the persistent symptoms of depression. The current study found that low economic status, low level of education, women, unmarried, age "65-year-old diabetic patients with the disease were readily [11-17] depression. Meanwhile, a total of disease in elderly patients with physical disease is a common cause of depression, total body disease severity of the disease can not afford to ignore the impact of depressive disorders. Physical disease patients with a total of more serious disease [18-21] has also increased the risk of depression. Most patients, the study found a total of depression in patients with diabetes, patients with depressive symptoms and poor diet. Drug Compliance low correlation [22] and other social dysfunction, and poor glycemic control. [23-26] decreased quality of life. and the family's feelings but also has negative impact on quality of life [27]. 2. Comorbidity of depression increased the economic burden of disease : diabetes patients with depression after increasing the burden on the individual and society. outstanding performance of the economy in the treatment of patients with increased direct costs, indirect costs, and overall costs. American Diabetes Association 1997 direct treatment of diabetes research in the United States (including a total of disease treatment complications of the treatment, blood glucose control treatment) and indirect costs (mainly early death and disease, disability) composition diabetes and other chronic diseases as well as the comparative costs. Diabetic patients found the proportion of direct and indirect costs. The overall cost of treatment is more than four-fold [28] and other chronic diseases. Hogan & Using the same method, the study of diabetes in the United States in 2002 the cost of treatment [29]. Barcelo analysis of the Latin America and other regions Tekle than the treatment of diabetes [30]. Henriksson, such as analysis of the treatment of diabetes in Switzerland in 1994. and the United States in 1978 and its four similar study conducted earlier, Several studies have found over the same [31]. Callahan study of antidepressant treatment and diagnosis and severity of the symptoms. After a one-year follow-up of 508 patients found that the costs of health care : diagnosis and symptoms. no direct costs associated with antidepressant treatment [32]. Simon's study found that depression and anxiety in patients with primary medical care and high-cost medical services requested more relevant, Antidepressants and other anti-anxiety is not caused by psychological therapy [33]. Above Ciechanowski as a result of depression after the disease has found the high cost of health care [8]. Leonard similar to the findings of the study, diabetic patients with the disease were not, total cost of emergency room patients with the disease of depression, drugs and general medical costs were significantly higher [16]. Eric study of depression in elderly patients with diabetes and the rate of total costs. Depression in elderly diabetic patients were found to be 1.5 times higher in patients with other diseases of old age (OR 1.58 ± 0.05) [ 34]. The above results suggest that the increases in medical expenses was mainly due to the impact of negative emotion. The increase in non-essential costs and indirect result of the treatment. Therefore attracted many foreign scholars on the premise of the market economy and improve efficiency, A total of antidepressant treatment for patients and the effect of cost-effectiveness analysis in the study. 3. Comorbidity of depression analyzed the cost-effectiveness of antidepressant treatment : Health Economics that the cost-effectiveness analysis can be used to reduce morbidity and enhance the quality of life. The results are expected to show [35-36] natural units, Rubin and other recent summary of the total number of diabetic patients with depression and the adverse consequences of such interventions, be relatively sure that the same conclusion [37], a total of antidepressant treatment of patients. increase compliance, improve doctor-patient relationship and increase the organization's sensitivity to insulin, thereby reducing complications. improve the quality of life, and so that the total of antidepressant treatment for patients. Both psychological treatment or medication is a good cost-effective measure. Drug interactions, drug selection in a large number of clinical research. Lustman other Nortriptyline treatment of depressive illness in patients with diabetes. [38] found that patients with lower concentrations of HbA1c. Goodnick reviewed the nearly 10 years of experiments on animals and clinical studies, to sum up : 5-TH increase in the precursors for his release, or inhibit absorption and metabolism, increase insulin sensitivity. lowering blood glucose concentrations [40]. Cheer study found fluoxetine in the treatment of type II diabetes and hypoglycemia in patients with impaired glucose tolerance were improved. Other studies have supported the majority of diabetes patients control blood glucose in patients with depression use of fluoxetine [39-41] . 4. Total domestic diabetic patients with depression : study In recent years, domestic disease of diabetes and results of the study abroad basically the same information. Liu such as : Summary of the results of numerous studies that diabetes can lead to many psychological problems, psychological problems would affect [6,41] metabolic control of diabetes. Endocrine study results showed that diabetic patients with a negative emotion [42]. Diabetes without obvious psycho-social problems, the performance of loneliness, depression, increased incidence of suicide. cognitive impairment; Psychological process anomalies; [6] The decrease in the quality of life. Xiang-Hong meta-analysis conducted in diabetic patients with depression who, treatment and care of diabetes affect the level of cooperation, active treatment can persist with diet, If long-term depressed mood persists, it may increase the risk of suicide, as high as 10%. Depression treatment, depression treatment of diabetes, must take account of both. Choice of the new generation selective serotonin joint inhibitor (SSRA) better. [43-46] long term antidepressant therapy. Wang Wei part of the study found that diabetic patients with psychological treatment, depression, anxiety elimination ideal glycemic control, significant improvements in the quality of life of patients [21]. 5. The current study abroad : the lack of research on the cost-effectiveness of the markedly increased in recent years, but very little domestic research. In view of the average medical conditions and lack of resources, should step up to the national medical cost-effectiveness of diabetes patients in the depression study. Summary : diabetes (mainly type II diabetes), the prevalence rate tended to rise on a global scale. faster increase, especially in developing countries, since China carried out four surveys since 1978. The prevalence of diabetes and impaired glucose tolerance has increased to 7.1% in 1996. Along with the changes to the medical model, the researcher noted, Diabetes is a chronic disease patients and relatives to bring psychological pressure, depression easy comorbidity, diabetes, A total of complications and disease threatens not only the health and safety of life and reduce the quality of life, but a heavy financial burden. Along with economic development, social progress, more and more medical workers in the active disease, To relieve pain at the same time, has begun to pay great attention to effectiveness analysis, in order to save the limited resources to serve more patients. Analysis of the data support the effectiveness of the foreign total of antidepressant treatment for patients with depressive illness. Drug choice SSRI drugs. However, the present study of the effect of antidepressant treatment cost less.