Is supported self-management for depression effective for adults in community-based settings in Vietnam?: a modified stepped-wedge cluster randomized controlled trial

International Journal of Mental Health Systems

Yue Ma¹  Wayne Jones²  John O’Neil²  Hayami Lou²  Leena W. Chau²  Jill K. Murphy³  Charles H. Goldsmith⁴  Hui Xie⁴  Tran Kieu Nhu⁵  Pham Thi Oanh⁵  Vu Cong Nguyen⁵  Harry Minas⁶  Nguyen Van Hoi⁷ 

[1] BC Centre for Excellence in HIV/AIDS;Centre for Applied Research in Mental Health & Addiction, Faculty of Health Sciences, Simon Fraser University;Department of Psychiatry, Faculty of Medicine, University of British Columbia, Mood Disorders Centre;Faculty of Health Sciences, Simon Fraser University;Institute of Population, Health and Development;Melbourne School of Population and Global Health, University of Melbourne;Ministry of Labour, Invalids and Social Affairs;

关键词: Task-sharing;    Depression;    Supported self-management;    Vietnam;   

DOI  :  10.1186/s13033-020-00342-1

来源: DOAJ

【 摘 要 】

Abstract Background This study tested the effectiveness of a supported self-management (SSM) intervention to reduce symptoms of depression among adults compared with enhanced treatment as usual in community-based and primary care settings in Vietnam. Methods The cluster randomized trial included 376 adults in 32 communes in eight provinces. Eligible participants scored > 7 on the SRQ-20 depression scale. Patients with severe symptoms were excluded and referred to tertiary care. Randomization took place at the commune level. The immediate intervention group included 16 communes with 190 participants and the delayed group included 16 communes with 186 participants. Participants in communes randomized to the immediate intervention group received a two-month course of SSM, consisting of a workbook and supportive coaching. Those in communes randomized to the delayed group received enhanced treatment as usual and, for ethical purposes, received the SSM intervention after 4 months. The primary outcome is the effect of SSM on reduction in depression scores as indicated by a reduced proportion of participants with SRQ-20 scores > 7 at 2 months after commencement of SSM intervention. Blinding was not possible during intervention delivery but outcome assessors were blinded. Analysis was intention-to-treat. Results At 2 months, 26.4% of the intervention group and 42.3% of the delayed group had SRQ-20 scores > 7. The adjusted odds ratio of having depression between the intervention and control was 0.42 (p < 0.0001), 95% CI (0.28, 0.63). Receiving the intervention thus reduces the odds of having depression by 58%, compared with receiving the control after 2 months of treatment. No adverse events were reported. Conclusions Results suggest that SSM is effective for decreasing depression symptoms among adults in community-based settings in Vietnam. Trial Registration This trial is registered at ClinicalTrials.gov, number NCT03001063.

【 授权许可】

Unknown