Abstract:
BACKGROUND:People who are diagnosed with both mental and chronic medical illness present unique challenges for the health care system. In resource-limited settings, such as rural India, people with depression and anxiety are often under-served, due to both stigma and lack of trained providers and resources. These challenges can lead to complications in the management of chronic disease as well as increased suffering for patients, families and communities. In this study, we evaluate the effects of integrating mental health and chronic disease treatment of patients in primary health care (PHC) settings using a collaborative care model to improve the screening, diagnosis and treatment of depression in rural India. METHODS:This study is a multi-level randomized controlled trial among patients with depression or anxiety and co-morbid diabetes, or cardiovascular disease. Aim 1 examines whether patients screened at community health-fairs are more likely to be diagnosed and treated for these co-morbid conditions than patients screened after presenting at PHCs. Aim 2 evaluates the impact of collaborative care compared to usual care in a cluster RCT, randomizing at the level of the PHCs. Intervention arm PHC staff are trained in mental health diagnoses, treatment, and the collaborative care model. The intervention also involves community-based "Healthy Living groups" co-led by Ashas, using cognitive-behavioral strategies to promote healthy behaviors. The primary outcome is severity of common mental disorders, with secondary outcomes being diabetes and cardiovascular risk, staff knowledge and patient perceptions. DISCUSSION:If effective, our results will contribute to the field in five ways: 1) expand on implementation research in low resource settings by examining how multiple chronic diseases can be treated using integrated low-cost, evidence-based strategies, 2) build the capacity of PHC staff to diagnose and treat mental illness within their existing clinic structure and strengthen referral linkages; 3) link community members to primary care through community-based health fairs and healthy living groups; 4) increase mental health awareness in the community and reduce mental health stigma; 5) demonstrate the potential for intervention scale-up and sustainability. TRIAL REGISTRATION:http://Clinicaltrials.gov : NCT02310932 registered December 8, 2014 URL: https://clinicaltrials.gov/ct2/show/record/NCT02310932 ; Clinical Trials Registry India: CTRI/2018/04/013001 retrospectively registered on April 4, 2018.
journal_name
BMC Fam Practjournal_title
BMC family practiceauthors
Srinivasan K,Mazur A,Mony PK,Whooley M,Ekstrand MLdoi
10.1186/s12875-018-0845-zsubject
Has Abstractpub_date
2018-09-11 00:00:00pages
158issue
1issn
1471-2296pii
10.1186/s12875-018-0845-zjournal_volume
19pub_type
杂志文章,随机对照试验abstract:BACKGROUND:Gout is estimated to affect 1.4% of adults in the UK. Appropriate and timely management is essential to reduce the risk of further flares, complications, and to reduce cardiovascular disease risk. The British Society for Rheumatology and British Health Professionals in Rheumatology (BSR/BHPR) and the Europea...
journal_title:BMC family practice
pub_type: 杂志文章
doi:10.1186/1471-2296-14-170
更新日期:2013-11-14 00:00:00
abstract:BACKGROUND:Many western countries are facing an existing or imminent shortage of primary care physicians especially in rural areas. In Germany, working in rural areas is often thought to be associated with more working hours, a higher number of patients and a lower income than working in urban areas. These perceptions ...
journal_title:BMC family practice
pub_type: 杂志文章
doi:10.1186/1471-2296-12-112
更新日期:2011-10-11 00:00:00
abstract:BACKGROUND:The Charlson comorbidity index is widely used in ICD-9 administrative data, however, there is no translation for Read/OXMIS coded data despite increasing use of the General Practice Research Database (GPRD). Our main objective was to translate the Charlson index for use with Read/OXMIS coded data such as the...
journal_title:BMC family practice
pub_type: 历史文章,杂志文章
doi:10.1186/1471-2296-11-1
更新日期:2010-01-05 00:00:00
abstract:BACKGROUND:It is argued that the ways in which women express emotional distress mean that they are more likely to be diagnosed with depression, while men's relative lack of articulacy means their depression is hidden. This may have consequences for communicating with health professionals. The purpose of this analysis w...
journal_title:BMC family practice
pub_type: 杂志文章
doi:10.1186/1471-2296-8-43
更新日期:2007-07-24 00:00:00
abstract:BACKGROUND:The vast majority of patients with diabetes have multiple chronic conditions, increasing complexity of care; however, clinical practice guidelines, interventions, and public reporting metrics do not adequately address the interaction of these multiple conditions. To advance the understanding of diabetes clin...
journal_title:BMC family practice
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doi:10.1186/s12875-015-0253-6
更新日期:2015-03-28 00:00:00
abstract:BACKGROUND:Better management of affective and somatoform disorders may reduce consultation rates in primary care. Somatoform disorders are highly prevalent in primary care and co-morbidity with affective disorders is substantial, but it is as yet unclear which portion of the health care use may be ascribed to each diso...
journal_title:BMC family practice
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更新日期:2008-01-24 00:00:00
abstract:BACKGROUND:The majority of patient contacts occur in general practice but general practice patient safety has been poorly described and under-researched to date compared to hospital settings. Our objective was to produce a set of patient safety tools and indicators that can be used in general practices in any healthcar...
journal_title:BMC family practice
pub_type: 杂志文章
doi:10.1186/1471-2296-15-110
更新日期:2014-06-05 00:00:00
abstract:BACKGROUND:Glycated hemoglobin (HbA1c) results vary by analytical method. Use of same-visit HbA1c testing methodology holds the promise of more efficient patient care, and improved diabetes management. Our objective was to test the feasibility of introducing a same-visit HbA1c methodology into busy family practice cent...
journal_title:BMC family practice
pub_type: 杂志文章
doi:10.1186/1471-2296-6-28
更新日期:2005-07-13 00:00:00
abstract:BACKGROUND:Recurrent urinary tract infections (RUTIs) are commonly presented by women in primary care. In order to explore the poorly described experience of women with RUTIs a qualitative study was conducted that analysed data from a publically accessible internet-based self-help forum. METHODS:Qualitative Descriptio...
journal_title:BMC family practice
pub_type: 杂志文章
doi:10.1186/1471-2296-15-162
更新日期:2014-09-26 00:00:00
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pub_type: 杂志文章
doi:10.1186/1471-2296-4-20
更新日期:2003-12-30 00:00:00
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pub_type: 杂志文章
doi:10.1186/s12875-016-0410-6
更新日期:2016-02-02 00:00:00
abstract:BACKGROUND:A cluster randomised trial was conducted to determine the effectiveness of locally adapted practice guidelines and education about paediatric asthma management, delivered to general practitioners (GPs) in small group interactive workshops. METHODS:Twenty-nine practices were randomly allocated to one of thre...
journal_title:BMC family practice
pub_type: 杂志文章,随机对照试验
doi:10.1186/1471-2296-9-22
更新日期:2008-04-20 00:00:00
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pub_type: 杂志文章
doi:10.1186/s12875-020-01166-1
更新日期:2020-06-08 00:00:00
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pub_type: 杂志文章
doi:10.1186/s12875-017-0693-2
更新日期:2018-01-12 00:00:00
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pub_type: 杂志文章
doi:10.1186/1471-2296-14-7
更新日期:2013-01-08 00:00:00
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更新日期:2020-04-22 00:00:00
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pub_type: 杂志文章
doi:10.1186/s12875-016-0529-5
更新日期:2016-09-08 00:00:00
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pub_type: 杂志文章
doi:10.1186/1471-2296-12-142
更新日期:2011-12-29 00:00:00
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pub_type: 杂志文章
doi:10.1186/s12875-018-0875-6
更新日期:2018-11-29 00:00:00
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pub_type: 杂志文章
doi:10.1186/1471-2296-11-73
更新日期:2010-10-06 00:00:00
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更新日期:2017-09-11 00:00:00
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更新日期:2012-03-12 00:00:00
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更新日期:2012-07-16 00:00:00
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更新日期:2015-10-13 00:00:00
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journal_title:BMC family practice
pub_type: 杂志文章
doi:10.1186/1471-2296-10-60
更新日期:2009-08-26 00:00:00
abstract::The editors have retracted this article [1] because it contains extensive overlap with an article published by the same authors in the Journal of Family & Community Medicine [2] and is therefore redundant. ...
journal_title:BMC family practice
pub_type: 杂志文章,撤回出版物
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更新日期:2019-11-05 00:00:00
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journal_title:BMC family practice
pub_type: 杂志文章
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更新日期:2015-11-11 00:00:00