How faithfully do HIV clinicians administer the PHQ-9 depression screening tool in high-volume, low-resource clinics? Results from a depression treatment integration project in Malawi.
LMICs
PHQ-9
depression
integration
reliability
screening
Journal
Global mental health (Cambridge, England)
ISSN: 2054-4251
Titre abrégé: Glob Ment Health (Camb)
Pays: England
ID NLM: 101659641
Informations de publication
Date de publication:
2019
2019
Historique:
received:
22
05
2019
revised:
02
08
2019
accepted:
21
08
2019
entrez:
31
10
2019
pubmed:
31
10
2019
medline:
31
10
2019
Statut:
epublish
Résumé
Integration of mental health services into nonspecialist settings is expanding in low and middle income countries (LMICs). Among many factors required for success, such programs require reliable administration of mental health screening tools. While several tools have been validated in carefully conducted research studies, few studies have assessed how reliably nonspecialist clinicians administer these tools to low-literacy LMIC populations in routine care. Ninety-seven patients accessing human immunodeficiency virus primary care in Malawi who completed Patient Health Questionnaire (PHQ)-9 depression screening with their clinician then completed a second PHQ-9 with a trained research assistant (RA) blinded to the first result. Compared to clinicians, RAs identified more patients with any depressive symptoms (PHQ-9 score ⩾5: 38% In routine care in LMICs, clinicians may administer validated mental health screening tools with varying quality. To ensure quality, integration programs must incorporate appropriate and ongoing training, support, supervision, and monitoring.
Sections du résumé
BACKGROUND
BACKGROUND
Integration of mental health services into nonspecialist settings is expanding in low and middle income countries (LMICs). Among many factors required for success, such programs require reliable administration of mental health screening tools. While several tools have been validated in carefully conducted research studies, few studies have assessed how reliably nonspecialist clinicians administer these tools to low-literacy LMIC populations in routine care.
METHODS
METHODS
Ninety-seven patients accessing human immunodeficiency virus primary care in Malawi who completed Patient Health Questionnaire (PHQ)-9 depression screening with their clinician then completed a second PHQ-9 with a trained research assistant (RA) blinded to the first result.
RESULTS
RESULTS
Compared to clinicians, RAs identified more patients with any depressive symptoms (PHQ-9 score ⩾5: 38%
CONCLUSIONS
CONCLUSIONS
In routine care in LMICs, clinicians may administer validated mental health screening tools with varying quality. To ensure quality, integration programs must incorporate appropriate and ongoing training, support, supervision, and monitoring.
Identifiants
pubmed: 31662876
doi: 10.1017/gmh.2019.22
pii: 00022
pmc: PMC6796321
doi:
Types de publication
Journal Article
Langues
eng
Pagination
e21Informations de copyright
© The Author(s) 2019.
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