Baron_et_al-2018-BMC_Psychiatry.pdf (405.69 kB)
Impact of district mental health care plans on symptom severity and functioning of patients with priority mental health conditions: the Programme for Improving Mental Health Care (PRIME) cohort protocol
journal contribution
posted on 2023-06-09, 12:31 authored by Emily C Baron, Sujit D Rathod, Charlotte Hanlon, Martin Prince, Abe WassieAbe Wassie, Fred Kigozi, Mark Jordans, Nagendra P Luitel, Girmay Medhin, Vaibhav Murhar, Juliet Nakku, Vikram Patel, Inge Petersen, One Selohilwe, Rahul Shidhaye, Joshua Ssebunny, Mark Tomlinson, Crick Lund, Mary De SilvaBackground: The Programme for Improving Mental Health Care (PRIME) sought to implement mental health care plans (MHCP) for four priority mental disorders (depression, alcohol use disorder, psychosis and epilepsy) into routine primary care in five low- and middle-income country districts. The impact of the MHCPs on disability was evaluated through establishment of priority disorder treatment cohorts. This paper describes the methodology of these PRIME cohorts. Methods: One cohort for each disorder was recruited across some or all five districts: Sodo (Ethiopia), Sehore (India) , Chitwan (Nepal), Dr. Kenneth Kaunda (South Africa) and Kamuli (Uganda), comprising 17 treatment cohorts in total (N = 2182). Participants were adults residing in the districts who were eligible to receive mental health treatment according to primary health care staff, trained by PRIME facilitators as per the district MHCP. Patients who screened positive for depression or AUD and who were not given a diagnosis by their clinicians (N = 709) were also recruited into comparison cohorts in Ethiopia, India, Nepal and South Africa. Caregivers of patients with epilepsy or psychosis were also recruited (N = 953), together with or on behalf of the person with a mental disorder, depending on the district. The target sample size was 200 (depression and AUD), or 150 (psychosis and epilepsy) patients initiating treatment in each recruiting district. Data collection activities were conducted by PRIME research teams. Participants completed follow-up assessments after 3 months (AUD and depression) or 6 months (psychosis and epilepsy), and after 12 months. Primary outcomes were impaired functioning, using the 12-item World Health Organization Disability Assessment Schedule 2.0 (WHODAS), and symptom severity, assessed using the Patient Health Questionnaire (depression), the Alcohol Use Disorder Identification Test (AUD), and number of seizures (epilepsy). Discussion: Cohort recruitment was a function of the clinical detection rate by primary health care staff, and did not meet all planned targets. The cross-country methodology reflected the pragmatic nature of the PRIME cohorts: while the heterogeneity in methods of recruitment was a consequence of differences in health systems and MHCPs, the use of the WHODAS as primary outcome measure will allow for comparison of functioning recovery across sites and disorders.
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Publication status
- Published
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- Published version
Journal
BMC PsychiatryISSN
1471-244XPublisher
BioMed CentralExternal DOI
Issue
61Volume
18Department affiliated with
- Global Health and Infection Publications
Research groups affiliated with
- Wellcome Trust Brighton and Sussex Centre for Global Health Research Publications
Full text available
- Yes
Peer reviewed?
- Yes
Legacy Posted Date
2018-03-20First Open Access (FOA) Date
2018-03-20First Compliant Deposit (FCD) Date
2018-03-20Usage metrics
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