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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.
- Source :
- Community Mental Health Journal; Oct2023, Vol. 59 Issue 7, p1261-1274, 14p, 5 Charts
- Publication Year :
- 2023
-
Abstract
- Depressive 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. [ABSTRACT FROM AUTHOR]
- Subjects :
- EDUCATION of physicians
DIAGNOSIS of mental depression
EVALUATION of medical care
HIV infections
ANTIDEPRESSANTS
PRIMARY nursing
EVALUATION of human services programs
COUNSELING
CHRONIC diseases
TASK performance
PRIMARY health care
COMPARATIVE studies
MENTAL depression
INTERPROFESSIONAL relations
MEDICAL referrals
QUESTIONNAIRES
PATIENT care
INTEGRATED health care delivery
NURSE practitioners
GROUP process
LONGITUDINAL method
OUTPATIENT services in hospitals
COMORBIDITY
MENTAL health services
MEDICAL needs assessment
EVALUATION
Subjects
Details
- Language :
- English
- ISSN :
- 00103853
- Volume :
- 59
- Issue :
- 7
- Database :
- Complementary Index
- Journal :
- Community Mental Health Journal
- Publication Type :
- Academic Journal
- Accession number :
- 170081932
- Full Text :
- https://doi.org/10.1007/s10597-023-01108-y