Treating depression in primary care in low-income women in Santiago, Chile: a randomised controlled trial
Treating depression in primary care in low-income women in Santiago, Chile: a randomised controlled trial
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DOI：
10.1016/s0140-6736(03)12825-5
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发表时间：
2003-03-22
期刊：
影响因子：
168.9
通讯作者：
Peters, TJ
中科院分区：
文献类型：
--
作者：
Araya, R;Rojas, G;Peters, TJ
女性抑郁症是初级保健中遇到的最常见的问题之一。我们的目的是比较在智利圣地亚哥低收入妇女抑郁症的初级保健管理中，逐步护理方案与常规护理的有效性。方法在一项随机对照试验中，在智利的三个初级保健诊所，240名患有重度抑郁症的成年女性初级保健患者被分配到阶梯护理或常规护理。阶梯式护理是由一名非医疗卫生工作者领导的为期3个月的多成分干预，其中包括心理教育小组干预、结构化和系统的随访以及对严重抑郁症患者的药物治疗。数据以意向治疗为基础进行分析。主要结果测量是汉密尔顿抑郁评定量表（HDRS），在基线和随机化后3个月和6个月进行。大约90%的随机患者完成了结果评估。在所有支持逐步护理方案的结果测量指标中，组间存在显著差异。两组间调整后的平均HDRS评分差异为-8.89 (95% CI -11.15 ~ -6.76; p
Background Depression in women is one of the commonest problems encountered in primary care. We aimed to compare the effectiveness of a stepped-care programme with usual care in primary-care management of depression in low-income women in Santiago, Chile.Methods In a randomised controlled trial, in three primary-care clinics in Chile, 240 adult female primary-care patients with major depression were allocated stepped care or usual care. Stepped care was a 3-month, multicomponent intervention led by a non-medical health worker, which included a psychoeducational group intervention, structured and systematic follow-up, and drug treatment for patients with severe depression. Data were analysed on an intention-to-treat basis. The primary outcome measure was the Hamilton depression rating scale (HDRS) administered at baseline and at 3 and 6 months after randomisation.Findings About 90% of randomised patients completed outcome assessments. There was a substantial between-group difference in all outcome measures in favour of the stepped-care programme. The adjusted difference in mean HDRS score between the groups was -8.89 (95% CI -11.15 to -6.76; p