| Title |
Feasibility, Safety, Acceptability, and Preliminary Efficacy of Measurement-Based Care Depression Treatment for HIV Patients in Bamenda, Cameroon
|
|---|---|
| Published in |
AIDS and Behavior, February 2014
|
| DOI | 10.1007/s10461-014-0727-x |
| Pubmed ID | |
| Authors |
Brian W. Pence, Bradley N. Gaynes, Julius Atashili, Julie K. O’Donnell, Dmitry Kats, Kathryn Whetten, Alfred K. Njamnshi, Tabenyang Mbu, Charles Kefie, Shantal Asanji, Peter Ndumbe |
| Abstract |
Depression affects 18-30 % of HIV-infected patients in Africa and is associated with greater stigma, lower antiretroviral adherence, and faster disease progression. However, the region's health system capacity to effectively identify and treat depression is limited. Task-shifting models may help address this large mental health treatment gap. Measurement-Based Care (MBC) is a task-shifting model in which a Depression Care Manager guides a non-psychiatric (e.g., HIV) provider in prescribing and managing antidepressant treatment. We adapted MBC for depressed HIV-infected patients in Cameroon and completed a pilot study to assess feasibility, safety, acceptability, and preliminary efficacy. We enrolled 55 participants; all started amitriptyline 25-50 mg daily at baseline. By 12 weeks, most remained at 50 mg daily (range 25-125 mg). Median (interquartile range) PHQ-9 depressive severity scores declined from 13 (12-16) (baseline) to 2 (0-3) (week 12); 87 % achieved depression remission (PHQ-9 <5) by 12 weeks. Intervention fidelity was high: HIV providers followed MBC recommendations at 96 % of encounters. Most divergences reflected a failure to increase dose when indicated. No serious and few bothersome side effects were reported. Most suicidality (prevalence 62 % at baseline; 8 % at 12 weeks) was either passive or low-risk. Participant satisfaction was high (100 %), and most participants (89 %) indicated willingness to pay for medications if MBC were implemented in routine care. The adapted MBC intervention demonstrated high feasibility, safety, acceptability, and preliminary efficacy in this uncontrolled pilot study. Further research should assess whether MBC could improve adherence and HIV outcomes in this setting. |
X Demographics
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Geographical breakdown
| Country | Count | As % |
|---|---|---|
| United States | 1 | 100% |
Demographic breakdown
| Type | Count | As % |
|---|---|---|
| Members of the public | 1 | 100% |
Mendeley readers
The data shown below were compiled from readership statistics for 162 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Unknown | 162 | 100% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Student > Master | 34 | 21% |
| Researcher | 23 | 14% |
| Student > Ph. D. Student | 21 | 13% |
| Student > Postgraduate | 14 | 9% |
| Student > Bachelor | 11 | 7% |
| Other | 31 | 19% |
| Unknown | 28 | 17% |
| Readers by discipline | Count | As % |
|---|---|---|
| Medicine and Dentistry | 35 | 22% |
| Psychology | 25 | 15% |
| Nursing and Health Professions | 19 | 12% |
| Social Sciences | 16 | 10% |
| Neuroscience | 6 | 4% |
| Other | 23 | 14% |
| Unknown | 38 | 23% |
Attention Score in Context
This research output has an Altmetric Attention Score of 1. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 10 March 2014.
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#19,246,640
of 23,849,058 outputs
Outputs from AIDS and Behavior
#3,007
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Outputs of similar age
#166,531
of 226,641 outputs
Outputs of similar age from AIDS and Behavior
#44
of 56 outputs
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