Management of Depression in Chronic Care Patients Using a Task-Sharing Approach in a Real-World Primary Health Care Setting in South Africa: Outcomes of a Cohort Study
-
Published:2023-03-24
Issue:7
Volume:59
Page:1261-1274
-
ISSN:0010-3853
-
Container-title:Community Mental Health Journal
-
language:en
-
Short-container-title:Community Ment Health J
Author:
Kathree TasneemORCID, Bachmann Max, Bhana Arvin, Grant Merridy, Mntambo Ntokozo, Gigaba Sithabisile, Kemp C. G., Rao Deepa, Petersen Inge
Abstract
AbstractDepressive symptoms are common in South African primary care patients with chronic medical conditions, but are usually unrecognised and untreated. This study evaluated an integrated, task-sharing collaborative approach to management of depression comorbid with chronic diseases in primary health care (PHC) patients in a real-world setting. Existing HIV clinic counsellors provided a manualised depression counselling intervention with stepped-up referral pathways to PHC doctors for initiation of anti-depressant medication and/ or referral to specialist mental health services. Using a comparative group cohort design, adult PHC patients in 10 PHC facilities were screened with the Patient Health Questionnaire-9 with those scoring above the validated cut-off enrolled. PHC nurses independently assessed, diagnosed and referred patients. Referral for treatment was independently associated with substantial improvements in depression symptoms three months later. The study confirms the viability of task-shared stepped-up collaborative care for depression treatment using co-located counselling in underserved real-world PHC settings.
Funder
National Institutes of Health University of KwaZulu-Natal
Publisher
Springer Science and Business Media LLC
Subject
Psychiatry and Mental health,Public Health, Environmental and Occupational Health,Health (social science)
Reference51 articles.
1. Ali, M. K., Chwastiak, L., Poongothai, S., Emmert-Fees, K. M. F., Patel, S. A., & Anjana, R. M. (2020). Effect of a Collaborative Care Model on Depressive Symptoms and Glycated Hemoglobin, Blood Pressure, and Serum Cholesterol Among Patients With Depression and Diabetes in India: The INDEPENDENT Randomized Clinical Trial. JAMA, 324(7), 651–662. https://doi.org/10.1001/jama.2020.11747 2. Bhana, A., Mntambo, N., Gigaba, S. G., Luvuno, Z. P. B., Grant, M., Ackerman, D., & Petersen, I. (2019). Validation of a brief mental health screening tool for common mental disorders in primary healthcare. South African Medical Journal, 109, 278–283. 3. Bhana, A., Rathod, S. D., Selohilwe, O., Kathree, T., & Petersen, I. (2015). The validity of the Patient Health Questionnaire for screening depression in chronic care patients in primary health care in South Africa. Bmc Psychiatry, 15(1), 1–9. https://doi.org/10.1186/s12888-015-0503-0. 4. Bosanquet, K., Bailey, D., Gilbody, S., Harden, M., Manea, L., Nutbrown, S., & McMillan, D. (2015). Diagnostic accuracy of the Whooley questions for the identification of depression: A diagnostic meta-analysis. British Medical Journal Open, 5(12), e008913. https://doi.org/10.1136/bmjopen-2015-008913. 5. COGTA. (ND). Amajuba-District-Profile-Edited-Final Retrieved from https://www.cogta.gov.za/ddm/wp-content/uploads/2020/07/2020.07.04-Amajuba-District-Profile-Edited-Final.pdf
Cited by
1 articles.
订阅此论文施引文献
订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献
|
|