两种实施策略支持将抑郁症查和治疗纳入马拉维高血压和糖尿病护理 (SHARP):并行,集群随机,受控,实施试验
Brian W Pence1, Bradley N Gaynes2, Michael Udedi3
1Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
The Lancet. Global health
|February 26, 2024
概括
通过将内部冠军与外部监督相结合的增强战略,在低资源环境中显著改善了抑郁症治疗后续和缓解率. 这种方法是将精神卫生保健纳入慢性疾病管理的关键.
科学领域:
- 全球健康 全球健康
- 实施科学 实施科学
- 心理健康服务研究 心理健康服务研究
背景情况:
- 基于证据的抑郁症治疗方法存在,但在资源较少的环境中扩展它们是具有挑战性的.
- 将抑郁症护理整合到慢性医疗护理中需要有效的实施策略.
研究的目的:
- 为了比较两个实施策略,将抑郁症护理整合到高血压和糖尿病管理中.
- 改善患有并发疾病的患者的心理健康结果.
主要方法:
- 一个集群随机对照试验在马拉维的十个医疗机构中进行.
- 设施使用基本策略 (内部冠军) 或增强策略 (冠军加外部监督,审计和反).
- 该干预包括普遍的抑郁查,同行辅导和非专家管理.
主要成果:
- 强化组 (82%) 与基本组 (20%) 的治疗随访忠实度明显更高.
- 抑郁症缓解率在增强组 (55%) 与基本组 (36%) 相比显著更高.
- 在这两组中,查和治疗开始的忠实性都很高.
结论:
- 加强实施战略改善了后续治疗忠实度和抑郁症缓解率.
- 外部监督与内部冠军相结合,是将抑郁症治疗纳入低资源环境的一个有希望的方法.
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