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
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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.
In: PLOS ONE, Vol. 16, No. 8, e0255594, 2021.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
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TY - JOUR
T1 - 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
AU - O'Donnell, Amy
AU - Schulte, Bernd
AU - Manthey, Jakob
AU - Schmidt, Christiane Sybille
AU - Piazza, Marina
AU - Chavez, Ines Bustamante
AU - Natera, Guillermina
AU - Aguilar, Natalia Bautista
AU - Hernández, Graciela Yazmín Sánchez
AU - Mejía-Trujillo, Juliana
AU - Pérez-Gómez, Augusto
AU - Gual, Antoni
AU - de Vries, Hein
AU - Solovei, Adriana
AU - Kokole, Dasa
AU - Kaner, Eileen
AU - Kilian, Carolin
AU - Rehm, Jurgen
AU - Anderson, Peter
AU - Jané-Llopis, Eva
PY - 2021
Y1 - 2021
N2 - 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.
AB - 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.
KW - Adult
KW - Alcohol Drinking/adverse effects
KW - Alcoholic Intoxication/psychology
KW - Alcoholics/psychology
KW - Alcoholism/diagnosis
KW - Colombia/epidemiology
KW - Comorbidity
KW - Delivery of Health Care
KW - Depression/psychology
KW - Depressive Disorder/psychology
KW - Female
KW - Humans
KW - Male
KW - Mass Screening/methods
KW - Mexico/epidemiology
KW - Middle Aged
KW - Peru/epidemiology
KW - Primary Health Care/methods
KW - Referral and Consultation
KW - Substance Abuse Detection/methods
U2 - 10.1371/journal.pone.0255594
DO - 10.1371/journal.pone.0255594
M3 - SCORING: Journal article
C2 - 34352012
VL - 16
JO - PLOS ONE
JF - PLOS ONE
SN - 1932-6203
IS - 8
M1 - e0255594
ER -
