INtegration of DEPression Treatment into HIV Care in Uganda (INDEPTH-Uganda): study protocol for a randomized controlled trial.
INtegration of DEPression Treatment into HIV Care in Uganda (INDEPTH-Uganda): study protocol for a randomized controlled trial.
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DOI：
10.1186/1745-6215-15-248
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发表时间：
2014-06-25
期刊：
影响因子：
2.5
通讯作者：
Akena D
中科院分区：
文献类型：
--
作者：
Wagner GJ;Ngo V;Glick P;Obuku EA;Musisi S;Akena D
尽管撒哈拉以南非洲10%的艾滋病毒感染者患有临床抑郁症，抑郁症对关键公共卫生结果（艾滋病毒治疗依从性和安全套使用）的影响，但抑郁症治疗很少被纳入艾滋病毒护理计划。抑郁症护理的任务转移和协议化方法已被用于克服发展中国家心理健康专家的严重短缺，但在撒哈拉以南非洲地区和艾滋病毒客户中却没有。本试验的目的是评估乌干达艾滋病诊所抗抑郁治疗的任务转移，协议化模式的实施结果和成本效益。INDEPTH-Uganda是一项群集随机对照试验，比较了抑郁症护理的两种任务转移模式-一种协议化模式与一种依赖于训练有素的提供者的临床敏锐度在乌干达的10个公共卫生艾滋病毒诊所提供抑郁症护理的模式。除了从常规数据收集机制和监督日志中提取的数据外，还将从患者和提供者纵向队列中收集调查数据;在每个研究中心，将对根据PHQ-2筛选的150名医学上稳定的抑郁症患者随机样本进行12个月的随访，并对参与抑郁症护理实施的提供者进行24个月的随访。这些数据将用于评估两种模式在实施结果（筛查、诊断、治疗比例;提供者对护理模式的忠诚度）、提供者对治疗护理知识和实践的采用以及抑郁症缓解方面是否存在差异。将进行成本效益分析，以比较每个模式的资源相对使用情况。如果有效且资源高效，这种任务转移、协议化的模式将提供一种方法，用于建设撒哈拉以南非洲艾滋病毒护理环境中抑郁症治疗可持续整合的能力，并改善关键的公共卫生成果。INDEPTH-Uganda已在美国国立卫生研究院申办的临床试验登记处注册（2013年2月3日），并分配了标识符NCT 02056106。
Despite 10 to% of persons living with HIV in sub-Saharan Africa having clinical depression, and the consequences of depression for key public health outcomes (HIV treatment adherence and condom use), depression treatment is rarely integrated into HIV care programs. Task-shifting, protocolized approaches to depression care have been used to overcome severe shortages of mental health specialists in developing countries, but not in sub-Saharan Africa and not with HIV clients. The aims of this trial are to evaluate the implementation outcomes and cost-effectiveness of a task-shifting, protocolized model of antidepressant care for HIV clinics in Uganda. INDEPTH-Uganda is a cluster randomized controlled trial that compares two task-shifting models of depression care - a protocolized model versus a model that relies on the clinical acumen of trained providers to provide depression care in ten public health HIV clinics in Uganda. In addition to data abstracted from routine data collection mechanisms and supervision logs, survey data will be collected from patient and provider longitudinal cohorts; at each site, a random sample of 150 medically stable patients who are depressed according to the PHQ-2 screening will be followed for 12 months, and providers involved in depression care implementation will be followed over 24 months. These data will be used to assess whether the two models differ on implementation outcomes (proportion screened, diagnosed, treated; provider fidelity to model of care), provider adoption of treatment care knowledge and practices, and depression alleviation. A cost-effectiveness analysis will be conducted to compare the relative use of resources by each model. If effective and resource-efficient, the task-shifting, protocolized model will provide an approach to building the capacity for sustainable integration of depression treatment in HIV care settings across sub-Saharan Africa and improving key public health outcomes. INDEPTH-Uganda has been registered with the National Institutes of Health sponsored clinical trials registry (3 February 2013) and has been assigned the identifier NCT02056106.
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影响因子：
4.5
作者：
Callaghan M;Ford N;Schneider H
通讯作者：
Schneider H
影响因子：
11.8
作者：
Ivers, LC;Kendrick, D;Doucette, K
通讯作者：
Doucette, K
影响因子：
3.6
作者：
Glasgow, Russell E.;Askew, Sandy;Bennett, Gary G.
通讯作者：
Bennett, Gary G.
影响因子：
12.7
作者：
Cook, JA;Grey, D;Hessol, NA
通讯作者：
Hessol, NA
DOI：
10.1097/00042560-200208010-00005
发表时间：
2002-08-01
期刊：
JOURNAL OF ACQUIRED IMMUNE DEFICIENCY SYNDROMES
影响因子：
--
作者：
Cook, JA;Cohen, MH;Young, M
通讯作者：
Young, M