Can a primary health care intervention prevent diabetes in people with depression?

Collaborative care Collaborative care includes the use of both the Chronic Disease Management items (for pre-diabetes) and the GP Mental Health Treatment items (for depression) to prepare two separate but integrated, concurrent care plans. 1. GP Mental Health Treatment Plan for Depression The MBS (Medicare Benefits Schedule) items provide a structured framework for GPs to undertake early intervention, assessment and management of patients with mental disorders, as well as providing referral pathways to clinical psychologists, registered psychologists, and appropriately trained social workers and occupational therapists. *Psychological Services Eligible participants may be offered referrals for up to 10 individual services per calendar year. These will be used to assess and treat depression, and to identify and modify maladaptive behaviours (healthy behaviour modification counselling). Patients refusing to see the clinical psychologist will be offered counselling by the study GP as per usual care. The GP will complete the Mental Health Care Plan and refer the patient to the psychologist. The psychologist is required to send a report to the GP to document progress after 6 sessions and then the GP will write another referral for a further 4 sessions if deemed necessary. 2. Chronic Disease Management items for Pre-diabetes There are four relevant Chronic Disease Management items that provide rebates for study GPs to manage the ‘pre-diabetes’ by preparing, coordinating, reviewing or contributing to Chronic Disease Management plans. *Allied Health Services (Exercise Physiologists) A Medicare rebate is available for a maximum of 5 individual services per calendar year. Accredited exercise physiologists have the ability to combine general nutritional principles with exercise advice to increase the effectiveness of their health and wellbeing interventions, especially for weight loss. Participants will be encouraged to achieve a 5% reduction in weight per calendar year, and be advised to monitor and record their own weight weekly to promote weight-loss by the study GP. The GP will communicate this goal to the exercise physiologist, who is required to send a report to the GP to document progress after 5 sessions. Participants who smoke will be encouraged to discuss smoking cessation program options with the GP, given the excess risk of diabetes associated with active smoking.