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January 2011



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 Goa, India

Article Date: 14 Dec 2010 – 0:00 PST

A study published Online First by The Lancet shows that a trained lay counsellor-led collaborative care intervention can lead to an improvement in recovery from common disorders (CMD, such as depressionanxiety) among patients attending public primary care facilities, but a positive effect was not shown in patients at private facilities. The Article is by Professor Vikram Patel, Sangath Centre, Goa, India, and London School of Hygiene and Tropical Medicine, UK, and colleagues. The research was funded by The Wellcome Trust.

The prevalence of CMD in the people attending primary health centre is estimated at around 20% in developing countries. But there are several obstacles to providing effective interventions to real-world primary care settings in developing countries. These obstacles include the lack of skilled health workers, low recognition rate of these disorders by primary care doctors, the inadequate use of antidepressant drugs or psychosocial treatments, and low adherence to treatments. In this study, the MANAS trial, the authors aimed to test the effectiveness of an intervention led by lay health counsellors in primary care settings to improve outcomes of people with these disorders.

In this cluster randomised trial, primary care facilities in Goa, India, were assigned to intervention or control (enhanced usual care) groups. 24 study clusters, with an equal proportion of public and private facilities, were included. All adults who screened positive for CMD were eligible. The collaborative stepped-care intervention offered case management and psychosocial interventions, provided by a trained lay health counsellor, supplemented by antidepressant drugs by the primary care physician for patients with moderate or severe CMD and monthly supervision by a mental health specialist.

The primary outcome was recovery from common mental disorders as defined by the International Statistical Classification of Diseases and Related Health Problems-10th revision (ICD-10) at 6 months. and

Read in Full:  http://www.medicalnewstoday.com/articles/211157.php

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