Feasibility, experiences and outcomes of using DIALOG+ in primary care to improve quality of life and mental distress of patients with chronic conditions: an exploratory non-controlled trial in Bosnia and Herzegovina, Colombia and Uganda

Pilot and Feasibility Studies

Harriet Birabwa-Oketcho¹  Maja Muhić²  Hana Sikira²  Alma Džubur Kulenoviĉ²  Camilo Andrés Cabarique Méndez³  Carlos Gómez-Restrepo⁴  Nelson K. Sewankambo⁵  Dickens Akena⁶  Michael McGrath⁷  Francois van Loggerenberg⁷  Stefan Priebe⁷ 

[1] Butabika National Referral Mental Hospital, Kampala, Uganda;Clinical Center University of Sarajevo, Sarajevo, Bosnia and Herzegovina;Department of Clinical Epidemiology and Biostatistics, Pontificia Universidad Javeriana, Bogotá, Colombia;Department of Clinical Epidemiology and Biostatistics, Pontificia Universidad Javeriana, Bogotá, Colombia;Department of Psychiatry and Mental Health, Pontificia Universidad Javeriana, Bogotá, Colombia;Hospital Universitario San Ignacio, Bogotá, Colombia;Department of Internal Medicine, Makerere University College of Health Sciences, Kampala, Uganda;Department of Psychiatry, Makerere University College of Health Sciences, Kampala, Uganda;Unit for Social and Community Psychiatry, Queen Mary University of London, London, UK;

关键词: Global mental health;    Primary care;    Psychosocial interventions;    Resource-oriented approach;    LMICs;    Solution-focused;    Quality of life;    DIALOG+;   

DOI  :  10.1186/s40814-021-00914-z

来源: Springer

【 摘 要 】

BackgroundDIALOG+ is a resource-oriented and evidence-based intervention to improve quality of life and reduce mental distress. While it has been extensively studied in mental health care, there is little evidence for how to use it in primary care settings for patients with chronic physical conditions. Considering that DIALOG+ is used in existing routine patient-clinician meetings and is very low cost, it may have the potential to help large numbers of patients with chronic physical conditions, mental distress and poor quality of life who are treated in primary care. This is particularly relevant in low- and middle-income countries (LMICs) where resources for specialised services for such patients are scarce or non-existent.MethodsAn exploratory non-controlled trial will be conducted to primarily assess the feasibility and acceptability and, secondarily, outcomes of delivering DIALOG+ to patients with chronic physical conditions and poor quality of life in primary care settings in Bosnia and Herzegovina, Colombia and Uganda. Thirty patients in each country will receive DIALOG+ up to three times in monthly meetings over a 3-month period. Feasibility will be assessed by determining the extent to which the intervention is implemented as planned. Experiences will be captured in interviews and focus groups with care providers and participants to understand acceptability. Quality of life, symptoms of anxiety and depression, objective social situation and health status will be assessed at baseline and again after the three-session intervention.DiscussionThis study will inform our understanding of the extent to which DIALOG+ may be used in the routine care of patients with chronic physical conditions in different primary care settings. The findings of this exploratory trial can inform the design of future full randomised controlled trials of DIALOG+ in primary care settings in LMICs.Trial registrationAll studies were registered prospectively (on 02/12/2020 for Uganda and Bosnia and Herzegovina, and 01/12/2020 for Colombia) within the ISRCTN Registry. ISRCTN17003451 (Bosnia and Herzegovina), ISRCTN14018729 (Colombia) and ISRCTN50335796 (Uganda). Protocol version and date: v2.0; 28/07/2020 (Bosnia and Herzegovina), v0.3 02/08/2020 (Colombia) and v1.0, 05/11/2020 (Uganda).

【 授权许可】

CC BY