The effectiveness of depression management for improving HIV care outcomes in Malawi: protocol for a quasi-experimental study.
Depression
HIV/AIDS
Implementation science
Integration
Malawi
Mental health
Program evaluation
Retention
Sub-Saharan Africa
Task-shifting
Journal
BMC public health
ISSN: 1471-2458
Titre abrégé: BMC Public Health
Pays: England
ID NLM: 100968562
Informations de publication
Date de publication:
26 Jun 2019
26 Jun 2019
Historique:
received:
20
04
2019
accepted:
09
06
2019
entrez:
28
6
2019
pubmed:
28
6
2019
medline:
4
9
2019
Statut:
epublish
Résumé
Depression, prevalent among people living with HIV (PLWH) in Malawi, is associated with negative HIV patient outcomes and likely affects HIV medical management. Despite the high prevalence of depression, its management has not been integrated into HIV care in Malawi or most low-income countries. This study employs a pre-post design in two HIV clinics in Lilongwe, Malawi, to evaluate the effect of integrating depression management into routine HIV care on both mental health and HIV outcomes. Using a multiple baseline design, this study is examining mental health and HIV outcome data of adult (≥18 years) patients newly initiating ART who also have depression, comparing those entering care before and after the integration of depression screening and treatment into HIV care. The study is also collecting cost information to estimate the cost-effectiveness of the program in improving rates of depression remission and HIV treatment engagement and success. We anticipate that the study will generate evidence on the effect of depression management on HIV outcomes and the feasibility of integrating depression management into existing HIV care clinics. The results of the study will inform practice and policy decisions on integration of depression management in HIV care clinics in Malawi and related settings, and will help design a next-step strategy to scale-up integration to a larger scale. ClinicalTrials.gov ID [ NCT03555669 ]. Retrospectively registered on 13 June 2018.
Sections du résumé
BACKGROUND
BACKGROUND
Depression, prevalent among people living with HIV (PLWH) in Malawi, is associated with negative HIV patient outcomes and likely affects HIV medical management. Despite the high prevalence of depression, its management has not been integrated into HIV care in Malawi or most low-income countries.
METHODS
METHODS
This study employs a pre-post design in two HIV clinics in Lilongwe, Malawi, to evaluate the effect of integrating depression management into routine HIV care on both mental health and HIV outcomes. Using a multiple baseline design, this study is examining mental health and HIV outcome data of adult (≥18 years) patients newly initiating ART who also have depression, comparing those entering care before and after the integration of depression screening and treatment into HIV care. The study is also collecting cost information to estimate the cost-effectiveness of the program in improving rates of depression remission and HIV treatment engagement and success.
DISCUSSION
CONCLUSIONS
We anticipate that the study will generate evidence on the effect of depression management on HIV outcomes and the feasibility of integrating depression management into existing HIV care clinics. The results of the study will inform practice and policy decisions on integration of depression management in HIV care clinics in Malawi and related settings, and will help design a next-step strategy to scale-up integration to a larger scale.
TRIAL REGISTRATION
BACKGROUND
ClinicalTrials.gov ID [ NCT03555669 ]. Retrospectively registered on 13 June 2018.
Identifiants
pubmed: 31242877
doi: 10.1186/s12889-019-7132-3
pii: 10.1186/s12889-019-7132-3
pmc: PMC6595692
doi:
Banques de données
ClinicalTrials.gov
['NCT03555669']
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
827Subventions
Organisme : FIC NIH HHS
ID : D43 TW010060
Pays : United States
Organisme : USAID
ID : AID-OAA-14-00060
Références
Clin Infect Dis. 2018 Oct 15;67(9):1411-1418
pubmed: 29659757
Malawi Med J. 2018 Dec;30(4):236-242
pubmed: 31798801
Health Psychol. 2009 Jan;28(1):1-10
pubmed: 19210012
J Affect Disord. 2004 Jul;81(1):61-6
pubmed: 15183601
J Gen Intern Med. 2008 May;23(5):551-60
pubmed: 18247097
PLoS One. 2015 Oct 15;10(10):e0140001
pubmed: 26469186
AIDS Behav. 2012 Nov;16(8):2226-35
pubmed: 22451351
Am J Epidemiol. 2018 May 1;187(5):899-910
pubmed: 29036569
AIDS Behav. 2012 Nov;16(8):2101-18
pubmed: 22116638
AIDS Behav. 2013 Oct;17(8):2816-29
pubmed: 23812892
AIDS Patient Care STDS. 2012 Nov;26(11):647-54
pubmed: 23134559
AIDS. 2015 Sep 24;29(15):1975-86
pubmed: 26134881
BMC Fam Pract. 2007 Mar 05;8:7
pubmed: 17338822
Psychol Methods. 2014 Dec;19(4):493-510
pubmed: 24933294
Aust Fam Physician. 2012 Sep;41(9):676-9
pubmed: 22962642
Eur Psychiatry. 2007 Jan;22(1):9-15
pubmed: 17194572
Lancet. 2018 Nov 17;392(10160):2214-2228
pubmed: 30314860
Clin Psychol Rev. 2009 Jun;29(4):348-53
pubmed: 19299058
Ann Behav Med. 2014 Jun;47(3):259-69
pubmed: 24234601
Community Ment Health J. 2017 Feb;53(2):143-153
pubmed: 27221123
J Acquir Immune Defic Syndr. 2007 Feb 1;44(2):159-66
pubmed: 17146374
PLoS One. 2016 May 11;11(5):e0153132
pubmed: 27167852
BMC Public Health. 2011 Oct 26;11:828
pubmed: 22029430
Int J Soc Psychiatry. 2015 Mar;61(2):121-8
pubmed: 24903683
BMC Psychiatry. 2011 Sep 30;11:156
pubmed: 21961801
J Acquir Immune Defic Syndr. 2011 Oct 1;58(2):181-7
pubmed: 21857529
BMC Health Serv Res. 2012 Dec 05;12:444
pubmed: 23216919
BMC Health Serv Res. 2018 Jul 31;18(1):593
pubmed: 30064418
J Int Assoc Provid AIDS Care. 2017 Jan/Feb;16(1):91-97
pubmed: 28084190
J Consult Clin Psychol. 2012 Jun;80(3):404-15
pubmed: 22545737
Trans R Soc Trop Med Hyg. 2009 Jun;103(6):594-600
pubmed: 19298993
Arch Gen Psychiatry. 2010 Dec;67(12):1282-90
pubmed: 21135328
Int J Ment Health Syst. 2016 May 11;10:39
pubmed: 27175215
J Int Assoc Provid AIDS Care. 2014 Jul-Aug;13(4):335-41
pubmed: 23881909
Am J Public Health. 2013 Feb;103(2):308-15
pubmed: 22720766
AIDS Behav. 2014 Jun;18(6):1142-51
pubmed: 24558099
Med Care. 2004 Dec;42(12):1194-201
pubmed: 15550799
Psychol Med. 2014 Feb;44(3):657-66
pubmed: 23721658
N Engl J Med. 2011 Aug 11;365(6):493-505
pubmed: 21767103
Malawi Med J. 2011 Sep;23(3):85-8
pubmed: 23448002
Int J Psychiatry Med. 2012;43(2):105-17
pubmed: 22849034
BMC Pregnancy Childbirth. 2014 Dec 03;14:400
pubmed: 25467187
JAMA. 2016 Dec 27;316(24):2618-2626
pubmed: 28027368
Arch Intern Med. 2011 Jan 10;171(1):23-31
pubmed: 21220657
J Acquir Immune Defic Syndr. 2015 May 1;69(1):98-108
pubmed: 25942461
Int J Soc Psychiatry. 2014 Mar;60(2):155-61
pubmed: 23399989
Clin Infect Dis. 2013 May;56(9):1319-26
pubmed: 23249611
J Abnorm Psychol. 1971 Aug;78(1):107-26
pubmed: 4938262
Afr J AIDS Res. 2014;13(4):331-8
pubmed: 25555099
J Acquir Immune Defic Syndr. 2014 Mar 1;65(3):359-65
pubmed: 24189149
Trop Med Int Health. 2015 Jul;20(7):903-13
pubmed: 25754063
Psychiatr Q. 2008 Mar;79(1):43-53
pubmed: 18095166
Med J Aust. 2000 Jul 17;173(2):106-10
pubmed: 10937041
J Gen Intern Med. 2001 Sep;16(9):606-13
pubmed: 11556941
J Acquir Immune Defic Syndr. 2005 Apr 1;38(4):432-8
pubmed: 15764960
J Int AIDS Soc. 2014 Jul 30;17:18965
pubmed: 25085002
Clin Psychol Rev. 2007 Jan;27(1):46-57
pubmed: 16480801
JAMA. 2006 Aug 9;296(6):679-90
pubmed: 16896111