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Primary care-based screening and management of depression amongst heavy drinking patients: Interim secondary outcomes of a three-country quasi-experimental study in Latin America.
O'Donnell, Amy; Schulte, Bernd; Manthey, Jakob; Schmidt, Christiane Sybille; Piazza, Marina; Chavez, Ines Bustamante; Natera, Guillermina; Aguilar, Natalia Bautista; Hernández, Graciela Yazmín Sánchez; Mejía-Trujillo, Juliana; Pérez-Gómez, Augusto; Gual, Antoni; de Vries, Hein; Solovei, Adriana; Kokole, Dasa; Kaner, Eileen; Kilian, Carolin; Rehm, Jurgen; Anderson, Peter; Jané-Llopis, Eva.
  • O'Donnell A; Population Health Sciences Institute, Newcastle University, Newcastle Upon Tyne, United Kingdom.
  • Schulte B; Center for Interdisciplinary Addiction Research (ZIS), Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
  • Manthey J; Center for Interdisciplinary Addiction Research (ZIS), Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
  • Schmidt CS; Institute for Clinical Psychology and Psychotherapy, TU Dresden, Dresden, Germany.
  • Piazza M; Department of Psychiatry, Medical Faculty, University of Leipzig, Leipzig, Germany.
  • Chavez IB; Center for Interdisciplinary Addiction Research (ZIS), Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
  • Natera G; Mental Health, Alcohol, and Drug Research Unit, School of Public Health and Administration, Universidad Peruana Cayetano Heredia, Lima, Peru.
  • Aguilar NB; Mental Health, Alcohol, and Drug Research Unit, School of Public Health and Administration, Universidad Peruana Cayetano Heredia, Lima, Peru.
  • Hernández GYS; Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz, CDMX, Mexico.
  • Mejía-Trujillo J; Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz, CDMX, Mexico.
  • Pérez-Gómez A; Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz, CDMX, Mexico.
  • Gual A; Corporación Nuevos Rumbos, Bogotá, Colombia.
  • de Vries H; Corporación Nuevos Rumbos, Bogotá, Colombia.
  • Solovei A; Addictions Unit, Psychiatry Dept, Hospital Clínic, Barcelona, Spain.
  • Kokole D; Red de Trastornos Adictivos, Instituto Carlos III, Madrid, Spain.
  • Kaner E; Institut d'Investigacions Biomèdiques August Pi Sunyer (IDIBAPS), Barcelona, Spain.
  • Kilian C; Department of Health Promotion, CAPHRI Care and Public Health Research Institute, Maastricht University, Maastricht, The Netherlands.
  • Rehm J; Department of Health Promotion, CAPHRI Care and Public Health Research Institute, Maastricht University, Maastricht, The Netherlands.
  • Anderson P; Department of Health Promotion, CAPHRI Care and Public Health Research Institute, Maastricht University, Maastricht, The Netherlands.
  • Jané-Llopis E; Population Health Sciences Institute, Newcastle University, Newcastle Upon Tyne, United Kingdom.
PLoS One ; 16(8): e0255594, 2021.
Article in English | MEDLINE | ID: covidwho-1344156
ABSTRACT

INTRODUCTION:

Implementation of evidence-based care for heavy drinking and depression remains low in global health systems. We tested the impact of providing community support, training, and clinical packages of varied intensity on depression screening and management for heavy drinking patients in Latin American primary healthcare. MATERIALS AND

METHODS:

Quasi-experimental study involving 58 primary healthcare units in Colombia, Mexico and Peru randomized to receive (1) usual care (control); (2) training using a brief clinical package; (3) community support plus training using a brief clinical package; (4) community support plus training using a standard clinical package. Outcomes were proportion of (1) heavy drinking patients screened for depression; (2) screen-positive patients receiving appropriate support; (3) all consulting patients screened for depression, irrespective of drinking status.

RESULTS:

550/615 identified heavy drinkers were screened for depression (89.4%). 147/230 patients screening positive for depression received appropriate support (64%). Amongst identified heavy drinkers, adjusting for country, sex, age and provider profession, provision of community support and training had no impact on depression activity rates. Intensity of clinical package also did not affect delivery rates, with comparable performance for brief and standard versions. However, amongst all consulting patients, training providers resulted in significantly higher rates of alcohol measurement and in turn higher depression screening rates; 2.7 times higher compared to those not trained.

CONCLUSIONS:

Training using a brief clinical package increased depression screening rates in Latin American primary healthcare. It is not possible to determine the effectiveness of community support on depression activity rates due to the impact of COVID-19.
Subject(s)

Full text: Available Collection: International databases Database: MEDLINE Document Type: Article Main subject: Alcohol Drinking / Depression / Alcoholics Subject: Alcohol Drinking / Depression / Alcoholics Type of study: Diagnostic study / Prognostic study / Qualitative research / Screening study Language: English Journal: PLoS One Clinical aspect: Therapy Year: 2021

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Full text: Available Collection: International databases Database: MEDLINE Document Type: Article Main subject: Alcohol Drinking / Depression / Alcoholics Subject: Alcohol Drinking / Depression / Alcoholics Type of study: Diagnostic study / Prognostic study / Qualitative research / Screening study Language: English Journal: PLoS One Clinical aspect: Therapy Year: 2021
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