The Sub-Saharan Africa Regional Partnership (SHARP) for Mental Health Capacity-Building Scale-Up Trial: Study Design and Protocol.
The Sub-Saharan Africa Regional Partnership (SHARP) for Mental Health Capacity-Building Scale-Up Trial: Study Design and Protocol.
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DOI：
10.1176/appi.ps.202000003
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发表时间：
2021-07-01
期刊：
影响因子：
--
通讯作者：
Pence BW
中科院分区：
文献类型：
--
作者：
Gaynes BN;Akiba CF;Hosseinipour MC;Kulisewa K;Amberbir A;Udedi M;Zimba CC;Masiye JK;Crampin M;Amarreh I;Pence BW
抑郁症是全球死亡和残疾的主要原因，包括在低收入和中等收入国家（LMIC）。抑郁症通常与慢性疾病共存，与更差的临床结果相关。这种融合导致呼吁将LMIC的心理健康治疗与慢性病护理系统相结合。本文介绍了一项试验的协议和理由，该试验比较了两种不同的多方面实施方案的有效性和成本效益，以支持将循证抗抑郁药管理和心理治疗纳入马拉维的慢性非传染性疾病（NCD）诊所。使用约束随机化，撒哈拉以南非洲地区精神卫生能力建设伙伴关系（SHARP）将以1：1的比例随机分配10个非传染性疾病诊所，以实施内部协调员（IC）的基本实施战略，内部协调员是慢性病护理诊所内的提供者，通过提供培训，监督，操作和报告来支持抑郁症服务，而IC加上外部质量保证委员会（EQAC），还提供对干预组件交付的季度审计，并向提供者和健康管理团队提供反馈。我们将比较关键的实施结果（对干预的忠诚度），有效性结果（患者健康）和成本效益。我们将评估可能影响摄取和保真度的临床特征。这项试验将提供关键信息，指导马拉维卫生部在现有的非传染性疾病环境中加强抑郁症管理。SHARP试验将为提高马拉维和该地区的心理健康治疗和实施科学研究能力做出重大贡献。
Depression is a leading cause of death and disability worldwide, including in low- and middle-income countries (LMIC). Depression often co-exists with chronic medical conditions, where it is associated with worse clinical outcomes. This confluence has led to calls to integrate mental health treatment with chronic disease care systems in LMIC. This paper describes the protocol and rationale for a trial comparing the effectiveness and cost-effectiveness of two different multifaceted implementation packages to support integration of evidence-based antidepressant management and psychotherapy into chronic non-communicable diseases (NCD) clinics in Malawi. Using constrained randomization, the sub-Saharan Africa Regional Partnership for Mental Health Capacity Building (SHARP) will randomly assign 10 NCD clinics 1:1 to a basic implementation strategy of an Internal Coordinator (IC), a provider within the chronic care clinic who champions depression services by providing training, supervision, operations, and reporting, vs. IC plus an External Quality Assurance Committee (EQAC), which additionally provides a quarterly audit of intervention component delivery with feedback to providers and the health management team. We will compare key implementation outcomes (fidelity to intervention), effectiveness outcomes (patient health), and cost-effectiveness. We will assess clinic characteristics that may influence uptake and fidelity. This trial will provide key information to guide the Malawi Ministry of Health in scaling up depression management in existing NCD settings. The SHARP trial will make a substantial contribution toward enhancing both mental health treatment and implementation science research capacity in Malawi and the region.
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DOI：
10.1056/nejmoa1600693
发表时间：
2016-09-01
期刊：
The New England journal of medicine
影响因子：
--
作者：
Cohen MS;Chen YQ;McCauley M;Gamble T;Hosseinipour MC;Kumarasamy N;Hakim JG;Kumwenda J;Grinsztejn B;Pilotto JH;Godbole SV;Chariyalertsak S;Santos BR;Mayer KH;Hoffman IF;Eshleman SH;Piwowar-Manning E;Cottle L;Zhang XC;Makhema J;Mills LA;Panchia R;Faesen S;Eron J;Gallant J;Havlir D;Swindells S;Elharrar V;Burns D;Taha TE;Nielsen-Saines K;Celentano DD;Essex M;Hudelson SE;Redd AD;Fleming TR;HPTN 052 Study Team
通讯作者：
HPTN 052 Study Team
影响因子：
168.9
作者：
Lopez, Alan D.;Mathers, Colin D.;Murray, Christopher J. L.
通讯作者：
Murray, Christopher J. L.
影响因子：
4.9
作者：
Adams, Julie L.;Gaynes, Bradley N.;Pence, Brian W.
通讯作者：
Pence, Brian W.
影响因子：
120.7
作者：
Demyttenaere, K;Bruffaerts, R;Chatterji, S
通讯作者：
Chatterji, S
影响因子：
2.2
作者：
Parker, DR;Evangelou, E;Eaton, CB
通讯作者：
Eaton, CB