Training primary health care workers in mental health and its impact on diagnoses of common mental disorders in primary care of a developing country, Malawi: a cluster-randomized controlled trial.
BackgroundMental health problems are common in primary care, with prevalence rates of up to 40% reported in developing countries. The study aim was to evaluate the impact of a specially designed toolkit used to train primary health care (PHC) workers in mental health on the rates of diagnosed cases...
| Published in: | Psychological Medicine Vol. 44; no. 3; pp. 657 - 667 |
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| Main Authors: | , , |
| Format: | research tables/charts randomized controlled trial Journal Article |
| Published: |
Cambridge University Press
Feb2014
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| Online Access: | View this record in EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=104131786&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 104131786 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 00332917 6Q3 jtl: Psychological Medicine issn: 00332917 maglogo: N pubinfo: dt: Feb2014 vid: 44 iid: 3 pid: 15979 pub: Cambridge University Press artinfo: ui: 104131786 93450687 10.1017/S0033291713001141 NLM23721658 104131786 ppf: 657 ppct: 10 formats: tig: atl: Training primary health care workers in mental health and its impact on diagnoses of common mental disorders in primary care of a developing country, Malawi: a cluster-randomized controlled trial. aug: au: Kauye, F. Jenkins, R. Rahman, A. affil: College of Medicine, Blantyre, Malawi sug: subj: Health Personnel Education Primary Health Care Mental Disorders Diagnosis Human Malawi Randomized Controlled Trials Mental Health Outpatient Service Questionnaires Interview Guides Mental Disorders Epidemiology Depression Epidemiology Prevalence Pretest-Posttest Design Anxiety Odds Ratio Confidence Intervals Malaria Diagnosis Cross Sectional Studies Surveys Semi-Structured Interview Sample Size Data Analysis Software Regression Sensitivity and Specificity Male Female Descriptive Statistics Adult Funding Source Adult: 19-44 years Male Female ab: BackgroundMental health problems are common in primary care, with prevalence rates of up to 40% reported in developing countries. The study aim was to evaluate the impact of a specially designed toolkit used to train primary health care (PHC) workers in mental health on the rates of diagnosed cases of common mental disorders, malaria and non-specific musculoskeletal pains in primary care in Malawi.MethodClinics with out-patient services in the designated district were randomly divided into control and intervention arms. Using a two-phase sampling process, Self-Reporting Questionnaire scores, data on diagnoses made by PHC workers and results of the Structured Clinical Interview for DSM-IV for depression were collected from 837 consecutively attending adult patients in the pre-intervention study and 2600 patients in the post-intervention study.ResultsThe point prevalence rates for probable common mental disorder and depression were 28.8% and 19%, respectively. Rates for both anxiety and depression diagnoses by PHC workers at baseline were 0% in both arms. Following training, there were significant differences between the two arms in the rates of diagnosed cases of depression [9.2% v. 0.5%, odds ratio (OR) 32.1, 95% confidence interval (CI) 7.4–144.3, p ⩽ 0.001], anxiety (1.2% v. 0%, p ⩽ 0.001) and malaria (31% v. 40%, OR 0.62, 95% CI 0.43–0.89, p = 0.01). The intervention arm had more cases diagnosed with depression and anxiety while the control arm had more cases diagnosed with malaria.ConclusionsTraining of PHC workers in mental health with an appropriate toolkit will contribute significantly to the quality of detection and management of patients seen in primary care in developing countries. pubtype: Academic Journal doctype: research tables/charts randomized controlled trial Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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