低收入和中等收入国家常见精神疾病的协作护理:系统性审查和元分析
Mehreen Riaz Faisal1, Fakiha Tus Salam2, Aishwarya Lakshmi Vidyasagaran1
1Department of Health Sciences, University of York, York, UK.
Journal of affective disorders
|July 22, 2024
概括
在低收入和中等收入国家 (LMICs) 中,合作护理 (CC) 在短期和中期随访中有效治疗抑郁症. 对焦虑治疗的证据有限,长期影响需要进一步研究.
科学领域:
- 全球健康 全球健康
- 心理健康干预 心理健康干预
- 医疗保健服务研究 医疗服务研究
背景情况:
- 低收入和中等收入国家 (LMICs) 承受着常见精神疾病 (CMDs) 的高负担.
- 合作护理 (CC) 模式有效性的证据主要来自高收入国家 (HICs),可能无法对LMICs进行概括.
- 进行了一项系统性审查,以评估CC对CMD的有效性,特别是在LMIC环境中.
研究的目的:
- 系统地评估协作护理 (CC) 模式在低收入和中等收入国家 (LMICs) 治疗常见精神疾病 (CMDs) 的有效性.
- 综合来自LMICs成年人群中对抑郁和焦虑的CC干预的随机对照试验 (RCT) 的证据.
主要方法:
- 对八个数据库和两个试验注册表进行了全面搜索,涵盖了2011年至2023年11月期间发表的研究.
- 包括随机对照试验 (RCT),涉及被诊断患有抑郁症或焦虑症的成年人 (≥18岁),重点关注缓解或症状严重程度的变化.
- 随机效应的元分析对各种随访期进行 (短期:0-6个月,中期:7-12个月,长期:13-24个月,非常长期:≥25个月). 通过使用Cochrane RoB2工具来评估研究质量.
主要成果:
- 该审查包括12项试验,共有13,531名参与者;9项试验具有偏差风险较低.
- 协作护理 (CC) 在短期和中期随访 (二分和连续结果) 中表现出比常规抑郁症护理更高的有效性.
- 虽然CC在12个月内显示出对焦虑结果的有效性 (证据有限),但生活质量的改善在统计学上并不显著.
结论:
- 聚合估计表明,研究之间存在很高的异质性.
- 在LMICs中,CC在改善短期和中期随访中抑郁症结果方面比通常护理更有效.
- 对焦虑结果也观察到类似的改善,尽管支持证据有限.
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