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

dc.contributor.authorBaron, Emily C
dc.contributor.authorRathod, Sujit D
dc.contributor.authorHanlon, Charlotte
dc.contributor.authorPrince, Martin
dc.contributor.authorFedaku, Abebaw
dc.contributor.authorKigozi, Fred
dc.contributor.authorJordans, Mark
dc.contributor.authorLuitel, Nagendra P
dc.contributor.authorMedhin, Girmay
dc.contributor.authorMurhar, Vaibhav
dc.contributor.authorNakku, Juliet
dc.contributor.authorPatel, Vikram
dc.contributor.authorPetersen, Inge
dc.contributor.authorSelohilwe, One
dc.contributor.authorShidhaye, Rahul
dc.contributor.authorSsebunnya, Joshua
dc.contributor.authorTomlinson, Mark
dc.contributor.authorLund, Crick
dc.contributor.authorDe Silva, Mary
dc.date.accessioned2018-05-04T07:46:26Z
dc.date.available2018-05-04T07:46:26Z
dc.date.issued2018-03-06
dc.date.updated2018-04-09T15:11:04Z
dc.description.abstractBackground 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.
dc.identifier.apacitationBaron, E. C., Rathod, S. D., Hanlon, C., Prince, M., Fedaku, A., Kigozi, F., ... De Silva, M. (2018). 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. <i>BMC Psychiatry</i>, http://hdl.handle.net/11427/27927en_ZA
dc.identifier.chicagocitationBaron, Emily C, Sujit D Rathod, Charlotte Hanlon, Martin Prince, Abebaw Fedaku, Fred Kigozi, Mark Jordans, et al "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." <i>BMC Psychiatry</i> (2018) http://hdl.handle.net/11427/27927en_ZA
dc.identifier.citationBMC Psychiatry. 2018 Mar 06;18(1):61
dc.identifier.ris TY - Journal Article AU - Baron, Emily C AU - Rathod, Sujit D AU - Hanlon, Charlotte AU - Prince, Martin AU - Fedaku, Abebaw AU - Kigozi, Fred AU - Jordans, Mark AU - Luitel, Nagendra P AU - Medhin, Girmay AU - Murhar, Vaibhav AU - Nakku, Juliet AU - Patel, Vikram AU - Petersen, Inge AU - Selohilwe, One AU - Shidhaye, Rahul AU - Ssebunnya, Joshua AU - Tomlinson, Mark AU - Lund, Crick AU - De Silva, Mary AB - Background 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. DA - 2018-03-06 DB - OpenUCT DO - 10.1186/s12888-018-1642-x DP - University of Cape Town J1 - BMC Psychiatry LK - https://open.uct.ac.za PB - University of Cape Town PY - 2018 T1 - 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 TI - 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 UR - http://hdl.handle.net/11427/27927 ER - en_ZA
dc.identifier.urihttp://dx.doi.org/10.1186/s12888-018-1642-x
dc.identifier.urihttp://hdl.handle.net/11427/27927
dc.identifier.vancouvercitationBaron EC, Rathod SD, Hanlon C, Prince M, Fedaku A, Kigozi F, et al. 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. BMC Psychiatry. 2018; http://hdl.handle.net/11427/27927.en_ZA
dc.language.isoen
dc.publisherBioMed Central
dc.publisher.departmentCentre for Public Mental Healthen_ZA
dc.publisher.facultyFaculty of Health Sciencesen_ZA
dc.publisher.institutionUniversity of Cape Town
dc.rights.holderThe Author(s).
dc.sourceBMC Psychiatry
dc.source.urihttps://bmcpsychiatry.biomedcentral.com/
dc.subject.otherCohort; depression
dc.subject.otherAlcohol dependence
dc.subject.otherPsychosis
dc.subject.otherEpilepsy
dc.subject.otherLow-income populations
dc.subject.otherPrimary healthcare
dc.titleImpact 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
dc.typeJournal Article
uct.type.filetypeText
uct.type.filetypeImage
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