Resource-oriented interventions for patients with severe mental illnesses in low- and middle-income countries: trials in Bosnia-Herzegovina, Colombia and Uganda
Resource-oriented interventions for patients with severe mental illnesses in low- and middle-income countries: trials in Bosnia-Herzegovina, Colombia and Uganda
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DOI：
10.1186/s12888-019-2148-x
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发表时间：
2019-06-14
期刊：
影响因子：
4.4
通讯作者：
Bird, Victoria Jane
中科院分区：
文献类型：
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作者：
Priebe, Stefan;Fung, Catherine;Bird, Victoria Jane
研究背景严重精神疾病（SMI）是世界范围内的一个重大社会负担。低收入和中等收入国家通常没有足够的财政资源和合格的工作人员为重度精神病患者提供广泛的专业服务。因此，我们的研究旨在探索和测试低成本的干预措施，利用现有的资源，在常规的患者-临床医生会议，家庭和community.MethodsIn波斯尼亚-黑塞哥维那，哥伦比亚和乌干达，三个心理社会干预措施将进行测试，即通过DIALOG+，家庭参与多家庭小组会议的治疗效果，并支持患者与志愿者的交友计划。所有干预措施将提供给SMI患者，在6个月内实施，并在基线和6个月及12个月后进行评估。我们将开展9项试验，包括非对照试验、非随机对照试验和随机对照试验（RCT）。所有研究将使用核心结局标准。然而，研究交付的细节和额外的结果标准各不相同，以适应当地的情况，利益和优先事项。这些研究将分别进行分析，但可以选择比较和联合收割机的结果。如果成功实施，这些研究可以导致更广泛的研究，并有望为三个参与国家和其他LMICs的SMI患者的社区护理的卫生政策和临床实践提供信息。试验注册所有RCT均在ISRCTN Registry中进行前瞻性注册和非随机试验回顾性注册。（注册日期：2018年11月20日，前瞻性）;哥伦比亚DIALOG+：ISRCTN 83333181（注册日期：2018年11月20日，前瞻性）;波斯尼亚-黑塞哥维那DIALOG+：ISRCTN 13347129（注册日期：20/11/2018，前瞻性）;乌干达志愿者支持：ISRCTN 86689958（注册日期：04/03/2019，追溯）;哥伦比亚志愿者支持：ISRCTN 72241383（注册日期：04/03/2019，追溯）;波斯尼亚-黑塞哥维那志愿者支持：ISRCTN 51290984（注册日期：2018年11月20日，前瞻性）;乌干达家庭参与：ISRCTN 78948497（注册日期：04/03/2019，回顾性）;哥伦比亚家庭参与：ISRCTN 11440755（注册日期：2019年3月4日，回顾性）;波斯尼亚-黑塞哥维那家庭参与：ISRCTN 13347355（注册日期：2018年11月20日，前瞻性）。
BackgroundSevere mental illness (SMI) presents a major burden to societies worldwide. Low- and middle-income countries (LMICs) often do not have sufficient financial resources and qualified staff to provide extensive specialised services for outpatients with SMI. Our research therefore aims to explore and test low-cost interventions that use existing resources in routine patient-clinician meetings, families and communities.MethodsIn Bosnia-Herzegovina, Colombia and Uganda, three psychosocial interventions will be tested, i.e. making patient-clinician meetings therapeutically effective through DIALOG+, family involvement in multi-family group meetings, and support for patients in befriending schemes with volunteers. All interventions will be provided to patients with SMI, delivered over a six-month period and evaluated with assessments at baseline and after six and 12months. We will conduct nine trials including non-controlled trials, non-randomised controlled trials and randomised controlled trials (RCTs). Core outcome criteria will be used across all studies. However, details of study delivery and additional outcome criteria vary to accommodate local contexts, interests and priorities. The studies will be analysed separately, but with the option to compare and combine findings.DiscussionThe approach provides the opportunity to learn from commonalities and differences in the results and experiences across the three resource-oriented approaches and the three countries. If successfully implemented the studies can lead to more extensive research and are expected to inform health policies and clinical practice of community care for patients with SMI in the three participating countries and other LMICs.Trial registrationAll RCTs were registered prospectively and non-randomised trials retrospectively within the ISRCTN Registry.DIALOG+ in Uganda: ISRCTN25146122 (Date of Registration: 20/11/2018, prospective); DIALOG+ in Colombia: ISRCTN83333181 (Date of Registration: 20/11/2018, prospective); DIALOG+ in Bosnia-Herzegovina: ISRCTN13347129 (Date of Registration: 20/11/2018, prospective); Volunteer Support in Uganda: ISRCTN86689958 (Date of Registration: 04/03/2019, retrospective); Volunteer Support in Colombia: ISRCTN72241383 (Date of Registration: 04/03/2019, retrospective);Volunteer Support in Bosnia-Herzegovina: ISRCTN51290984 (Date of Registration: 20/11/2018, prospective); Family Involvement in Uganda: ISRCTN78948497 (Date of Registration: 04/03/2019, retrospective); Family Involvement in Colombia: ISRCTN11440755 (Date of Registration: 04/03/2019, retrospective); Family Involvement in Bosnia-Herzegovina: ISRCTN13347355 (Date of Registration: 20/11/2018, prospective).