期刊
COCHRANE DATABASE OF SYSTEMATIC REVIEWS
卷 -, 期 8, 页码 -出版社
WILEY
DOI: 10.1002/14651858.CD009149.pub3
关键词
Alcohol-Related Disorders [therapy]; *Allied Health Personnel; Anxiety [therapy]; Dementia [therapy]; Depression [therapy]; Depression; Postpartum [therapy]; *Developing Countries; Mental Disorders [*therapy]; Randomized Controlled Trials as Topic; Stress; Disorders; Post-Traumatic [therapy]; Substance-Related Disorders [*therapy]; Adult; Child; Female; Humans; Male; Pregnancy
资金
- Norwegian Agency for Development Cooperation (Norad), Norway
- Norwegian EPOC satellite
- Indian Council of Medical Research, India
- Prof. BV Moses & ICMR Centre for Advanced Research and Training in Evidence-Informed Healthcare
- Wellcome Trust, UK
- Clinical PhD Fellowship
- Senior Research Fellowship
- UKaid (Department of International Development), UK
- South Asian Cochrane Centre via Effective Health Care Research Consortium
- Foreign, Commonwealth and Development Office, UK [300342-104]
This study aimed to evaluate the effectiveness of primary-level workers in treating individuals with mental health symptoms in low- and middle-income countries. The results suggest that this intervention may have a moderate impact on improving patients’ quality of life, functioning, and service use.
Background Community-based primary-level workers (PWs) are an important strategy for addressing gaps in mental health service delivery in low- and middle-income countries. Objectives To evaluate the e)ectiveness of PW-led treatments for persons with mental health symptoms in LMICs, compared to usual care. Search methods MEDLINE, Embase, CENTRAL, ClinicalTrials.gov, ICTRP, reference lists (to 20 June 2019). Selection criteria Randomised trials of PW-led or collaborative-care interventions treating people with mental health symptoms or their carers in LMICs. PWs included: primary health professionals (PHPs), lay health workers (LHWs), community non-health professionals (CPs). Data collection and analysis Seven conditions were identified apriori and analysed by disorder and PW examining recovery, prevalence, symptom change, quality-oflife (QOL), functioning, service use (SU), and adverse events (AEs). Risk ratios (RRs) were used for dichotomous outcomes; mean di)erence (MDs), standardised mean di)erences (SMDs), or mean change di)erences (MCDs) for continuous outcomes. For SMDs, 0.20 to 0.49 represented small, 0.50 to 0.79 moderate, and O0.80 large clinical e)ects. Analysis timepoints: T1 (<1 month), T2 (1-6 months), T3 ( >6 months) post-intervention. Main results Description of studies 95 trials (72 new since 2013) from 30 LMICs (25 trials from 13 LICs). Risk of bias Most common: detection bias, attrition bias (e)icacy), insu)icient protection against contamination. Intervention e ects *Unless indicated, comparisons were usual care at T2. Probably, may, or uncertain indicates moderate, low, or very low certainty evidence.
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