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Published in: Trials 1/2015

Open Access 01-12-2015 | Study protocol

Comprehensive technology-assisted training and supervision program to enhance depression management in primary care in Santiago, Chile: study protocol for a cluster randomized controlled trial

Authors: Graciela Rojas, Pablo Martínez, Paul A. Vöhringer, Vania Martínez, Ariel Castro-Lara, Rosemarie Fritsch

Published in: Trials | Issue 1/2015

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Abstract

Background

Depression is a common and disabling condition. Since 2001, Chile has had a national program for depression in primary care and universal access to treatment for depressed people over the age of 15. There are National Guidelines to treat depression but no training program exists. The aim of the present study protocol is to measure the effectiveness of a comprehensive technology-assisted training and supervision program to enhance depression management in primary care.

Methods and design

This is a two-arm, single-blind, cluster randomized controlled trial to compare the efficacy of the program versus usual care to treat depression in primary care clinics. In total, 434 depressed persons 18 to 65 years of age, recruited from four primary care clinics located in Santiago, will participate in the study.

Discussion

In order to ensure the quality of interventions supported by the national program for depression in Chile, it is desirable to have training programs of proven effectiveness.

Trial registration

NCT02232854, registered on 2 September 2014.
Literature
1.
go back to reference Murray CJ, Lopez AD. The Global Burden of Disease: a comprehensive assessment of mortality and disability from disease, injuries and risk factors in 1990 and projected to 2020. Global Burden of Disease and Injury Series, vol. I. Cambridge, MA: Harvard School of Public Health; 1996. Murray CJ, Lopez AD. The Global Burden of Disease: a comprehensive assessment of mortality and disability from disease, injuries and risk factors in 1990 and projected to 2020. Global Burden of Disease and Injury Series, vol. I. Cambridge, MA: Harvard School of Public Health; 1996.
2.
go back to reference Araya R, Rojas G, Fritsh R, Acuña J, Lewis G. Common mental disorders in Santiago, Chile: Prevalence and socio-demographic correlates. Br J Psychiatry. 2001;178:228–33.CrossRefPubMed Araya R, Rojas G, Fritsh R, Acuña J, Lewis G. Common mental disorders in Santiago, Chile: Prevalence and socio-demographic correlates. Br J Psychiatry. 2001;178:228–33.CrossRefPubMed
3.
go back to reference Vicente B, Rioseco P, Valdivia S, Kohn R, Torres S. Estudio chileno de prevalencia de patología psiquiátrica (DSM-III-R/CIDI) (ECPP). Rev Med Chile. 2002;130:527–36.CrossRefPubMed Vicente B, Rioseco P, Valdivia S, Kohn R, Torres S. Estudio chileno de prevalencia de patología psiquiátrica (DSM-III-R/CIDI) (ECPP). Rev Med Chile. 2002;130:527–36.CrossRefPubMed
4.
go back to reference Goldberg DP, Lecrubier Y. Form and Frequency of Mental Disorders Across Centres. In: Üstün TB, Sartorius N, editors. Mental Illness in General Health Care: An International Study. Chichester. Chichester: John Wiley & Sons on behalf of WHO; 1995. p. 323–34. Goldberg DP, Lecrubier Y. Form and Frequency of Mental Disorders Across Centres. In: Üstün TB, Sartorius N, editors. Mental Illness in General Health Care: An International Study. Chichester. Chichester: John Wiley & Sons on behalf of WHO; 1995. p. 323–34.
5.
go back to reference Rojas G, Araya R, Fritsch R. Salud Mental, problemas psicosociales y atención primaria de salud. Acta Psiquiatr Psicol Am Lat. 2000;46(2):119–26. Rojas G, Araya R, Fritsch R. Salud Mental, problemas psicosociales y atención primaria de salud. Acta Psiquiatr Psicol Am Lat. 2000;46(2):119–26.
6.
go back to reference Patel V, Araya R, Chatterjee S, Chisholm D, Cohen A, De Silva M, et al. Treatment and prevention of mental disorders in low-income and middle-income countries. Lancet. 2007;370(9591):991–1005.CrossRefPubMed Patel V, Araya R, Chatterjee S, Chisholm D, Cohen A, De Silva M, et al. Treatment and prevention of mental disorders in low-income and middle-income countries. Lancet. 2007;370(9591):991–1005.CrossRefPubMed
7.
go back to reference National Collaborating Centre for Mental Health. Depression: The treatment and Management of Depression in Adults. Leicester and London: The British Psychological Society and The Royal College of Psychiatrists [NICE Guideline]; 2012. National Collaborating Centre for Mental Health. Depression: The treatment and Management of Depression in Adults. Leicester and London: The British Psychological Society and The Royal College of Psychiatrists [NICE Guideline]; 2012.
8.
go back to reference Araya R, Rojas G, Fritsch R, Gaete J, Rojas M, Simon G, et al. Treating depression in primary care in low income women in Santiago, Chile: a randomized controlled trial. Lancet. 2003;361(9362):995–1000.CrossRefPubMed Araya R, Rojas G, Fritsch R, Gaete J, Rojas M, Simon G, et al. Treating depression in primary care in low income women in Santiago, Chile: a randomized controlled trial. Lancet. 2003;361(9362):995–1000.CrossRefPubMed
9.
go back to reference Araya R, Flynn T, Rojas G, Fritsch R, Simon G. Cost-effectiveness of a primary care treatment program for depression in low-income women in Santiago. Chile Am J Psychiatry. 2006;163(8):1379–87.CrossRefPubMed Araya R, Flynn T, Rojas G, Fritsch R, Simon G. Cost-effectiveness of a primary care treatment program for depression in low-income women in Santiago. Chile Am J Psychiatry. 2006;163(8):1379–87.CrossRefPubMed
10.
go back to reference de Salud M. Guía Clínica Depresión en personas de 15 años y más. Santiago: MINSAL; 2013. de Salud M. Guía Clínica Depresión en personas de 15 años y más. Santiago: MINSAL; 2013.
13.
go back to reference de Salud M. Guía Clínica Tratamiento de Personas con Depresión. Santiago: MINSAL; 2009. de Salud M. Guía Clínica Tratamiento de Personas con Depresión. Santiago: MINSAL; 2009.
14.
go back to reference Alvarado R, Vega J, Sanhueza G, Muñoz MG. Evaluación del programa para la detección, diagnóstico y tratamiento integral de la depresión en atención primaria, en Chile. Rev Panam Salud Publica. 2005;18(4/5):278–86.PubMed Alvarado R, Vega J, Sanhueza G, Muñoz MG. Evaluación del programa para la detección, diagnóstico y tratamiento integral de la depresión en atención primaria, en Chile. Rev Panam Salud Publica. 2005;18(4/5):278–86.PubMed
15.
go back to reference Alvarado R, Rojas G. El Programa Nacional para el diagnóstico y tratamiento de depresión en Atención Primaria: una evaluación necesaria. Rev Med Chile. 2011;139(5):592–9.CrossRefPubMed Alvarado R, Rojas G. El Programa Nacional para el diagnóstico y tratamiento de depresión en Atención Primaria: una evaluación necesaria. Rev Med Chile. 2011;139(5):592–9.CrossRefPubMed
16.
go back to reference Kessler D, Lloyd K, Lewis G, Gray DP. Cross sectional study of symptom attribution and recognition of depression and anxiety in primary care. BMJ. 1999;318(7181):436–9.CrossRefPubMedPubMedCentral Kessler D, Lloyd K, Lewis G, Gray DP. Cross sectional study of symptom attribution and recognition of depression and anxiety in primary care. BMJ. 1999;318(7181):436–9.CrossRefPubMedPubMedCentral
17.
go back to reference Simon GE, Vonkorff M. Recognition, management, and outcomes of depression in primary care. Arch Fam Med. 1995;4(2):99–105.CrossRefPubMed Simon GE, Vonkorff M. Recognition, management, and outcomes of depression in primary care. Arch Fam Med. 1995;4(2):99–105.CrossRefPubMed
18.
go back to reference Lin EH, Simon GE, Katzelnick DJ, Pearson SD. Does physician education on depression management improve treatment in primary care? J Gen Intern Med. 2001;16(9):614–9.CrossRefPubMedPubMedCentral Lin EH, Simon GE, Katzelnick DJ, Pearson SD. Does physician education on depression management improve treatment in primary care? J Gen Intern Med. 2001;16(9):614–9.CrossRefPubMedPubMedCentral
19.
go back to reference Thompson C, Kinmonth AL, Stevens L, Peveler RC, Stevens A, Ostler KJ, et al. Effects of a clinical-practice guideline and practice-based education on detection and outcome of depression in primary care: Hampshire Depression Project randomised controlled trial. Lancet. 2000;355(9199):185–91.CrossRefPubMed Thompson C, Kinmonth AL, Stevens L, Peveler RC, Stevens A, Ostler KJ, et al. Effects of a clinical-practice guideline and practice-based education on detection and outcome of depression in primary care: Hampshire Depression Project randomised controlled trial. Lancet. 2000;355(9199):185–91.CrossRefPubMed
20.
go back to reference Katon W, Russo J, Von Korff M, Lin E, Simon G, Bush T, et al. Long-term effects of a collaborative care intervention in persistently depressed primary care patients. J Gen Intern Med. 2002;17(10):741–8.CrossRefPubMedPubMedCentral Katon W, Russo J, Von Korff M, Lin E, Simon G, Bush T, et al. Long-term effects of a collaborative care intervention in persistently depressed primary care patients. J Gen Intern Med. 2002;17(10):741–8.CrossRefPubMedPubMedCentral
21.
go back to reference Gilbody S, Whitty P, Grimshaw J, Thomas R. Educational and organizational interventions to improve the management of depression in primary care: a systematic review. JAMA. 2003;289(23):3145–51.CrossRefPubMed Gilbody S, Whitty P, Grimshaw J, Thomas R. Educational and organizational interventions to improve the management of depression in primary care: a systematic review. JAMA. 2003;289(23):3145–51.CrossRefPubMed
22.
go back to reference Addington D, Kyle T, Desai S, Wang J. Facilitators and barriers to implementing quality measurement in primary mental health care: Systematic review. Can Fam Physician. 2010;56(12):1322–31.PubMedPubMedCentral Addington D, Kyle T, Desai S, Wang J. Facilitators and barriers to implementing quality measurement in primary mental health care: Systematic review. Can Fam Physician. 2010;56(12):1322–31.PubMedPubMedCentral
24.
go back to reference Kroenke K, Spitzer RL, Williams JB, Lowe B. The patient health questionnaire somatic, anxiety, and depressive symptom scales: a systematic review. Gen Hosp Psychiatry. 2010;32(4):345–59.CrossRefPubMed Kroenke K, Spitzer RL, Williams JB, Lowe B. The patient health questionnaire somatic, anxiety, and depressive symptom scales: a systematic review. Gen Hosp Psychiatry. 2010;32(4):345–59.CrossRefPubMed
25.
go back to reference Baader T, Molina JL, Venezian S, Rojas C, Farías R, Fierro-Freixenet C, et al. Validación y utilidad de la encuesta PHQ-9 (Patient Health Questionnaire) en el diagnóstico de depresión en pacientes usuarios de atención primaria. Rev Chil Neuro-Psiquiat. 2012;50(1):10–22.CrossRef Baader T, Molina JL, Venezian S, Rojas C, Farías R, Fierro-Freixenet C, et al. Validación y utilidad de la encuesta PHQ-9 (Patient Health Questionnaire) en el diagnóstico de depresión en pacientes usuarios de atención primaria. Rev Chil Neuro-Psiquiat. 2012;50(1):10–22.CrossRef
26.
go back to reference Ware JE, Sherbourne CD. The MOS 36-item short-form health survey (SF-36) (I). Conceptual framework and item selection. Med Care. 1992;30:473–83.CrossRefPubMed Ware JE, Sherbourne CD. The MOS 36-item short-form health survey (SF-36) (I). Conceptual framework and item selection. Med Care. 1992;30:473–83.CrossRefPubMed
27.
go back to reference Garratt A, Schmidt L, Mackintosh A, Fitzpatrick R. Quality of life measurement: bibliographic study of patient assessed health outcome measures. BMJ. 2002;324:1417.CrossRefPubMedPubMedCentral Garratt A, Schmidt L, Mackintosh A, Fitzpatrick R. Quality of life measurement: bibliographic study of patient assessed health outcome measures. BMJ. 2002;324:1417.CrossRefPubMedPubMedCentral
29.
go back to reference Rojas G, Fritsch R, Solís J, González M, Guajardo V, Araya R. Calidad de vida de mujeres deprimidas en el posparto. Rev Med Chile. 2006;134(6):713–20.CrossRefPubMed Rojas G, Fritsch R, Solís J, González M, Guajardo V, Araya R. Calidad de vida de mujeres deprimidas en el posparto. Rev Med Chile. 2006;134(6):713–20.CrossRefPubMed
30.
go back to reference Rojas G, Fritsch R, Solis J, Jadresic E, Castillo C, González M, et al. Treatment of postnatal depression in low-income mothers in primary-care clinics in Santiago, Chile: a randomised controlled trial. Lancet. 2007;370(9599):1629–37.CrossRefPubMed Rojas G, Fritsch R, Solis J, Jadresic E, Castillo C, González M, et al. Treatment of postnatal depression in low-income mothers in primary-care clinics in Santiago, Chile: a randomised controlled trial. Lancet. 2007;370(9599):1629–37.CrossRefPubMed
31.
go back to reference Lambert MJ, Burlingame GM, Umphress V, Hansen NB, Vermeersch DA, Clouse GC, et al. The reliability and validity of the Outcome Questionnaire. Clin Psychol Psychot. 1996;3:249–58.CrossRef Lambert MJ, Burlingame GM, Umphress V, Hansen NB, Vermeersch DA, Clouse GC, et al. The reliability and validity of the Outcome Questionnaire. Clin Psychol Psychot. 1996;3:249–58.CrossRef
32.
go back to reference Lambert MJ, Kahler M, Harmon C, Burlingame GM, Shimokawa K. Administration & scoring manual for the Outcome Questionnaire-45.2. Salt Lake City: OQMeasures; 2011. Lambert MJ, Kahler M, Harmon C, Burlingame GM, Shimokawa K. Administration & scoring manual for the Outcome Questionnaire-45.2. Salt Lake City: OQMeasures; 2011.
33.
go back to reference De la Parra G, Von Bergen A, Del Río M. Primeros hallazgos de la aplicación de un instrumento que mide resultados psicoterapéuticos en una muestra de pacientes y de población general. Rev Chil Neuro-Psiquiat. 2002;40:201–9. De la Parra G, Von Bergen A, Del Río M. Primeros hallazgos de la aplicación de un instrumento que mide resultados psicoterapéuticos en una muestra de pacientes y de población general. Rev Chil Neuro-Psiquiat. 2002;40:201–9.
34.
go back to reference Correa J, Florenzano R, Rojas P, Labra J, Del Río V, Pastén J. El uso del cuestionario OQ-45.2 como indicador de psicopatología y de mejoría en pacientes psiquiátricos hospitalizados. Rev Chil Neuro-Psiquiat. 2006;44:258–62.CrossRef Correa J, Florenzano R, Rojas P, Labra J, Del Río V, Pastén J. El uso del cuestionario OQ-45.2 como indicador de psicopatología y de mejoría en pacientes psiquiátricos hospitalizados. Rev Chil Neuro-Psiquiat. 2006;44:258–62.CrossRef
35.
go back to reference Florenzano R, Artero M, González I, Martínez X, Ortega P. Evaluación del impacto de las intervenciones psicosociales en el nivel hospitalario de una Red de Atención de Salud Mental: aplicación sistemática del OQ 45.2 de Lambert. Rev Arg Clín Neuropsiquiátr. 2005;12:3–10. Florenzano R, Artero M, González I, Martínez X, Ortega P. Evaluación del impacto de las intervenciones psicosociales en el nivel hospitalario de una Red de Atención de Salud Mental: aplicación sistemática del OQ 45.2 de Lambert. Rev Arg Clín Neuropsiquiátr. 2005;12:3–10.
36.
go back to reference Fritsch R, Araya R, Solis J, Montt ME, Pilowsky D, Rojas G. Ensayo clínico randomizado de farmacoterapia con monitorización telefónica para mejorar el tratamiento de la depresión en la atención primaria en Santiago. Chile Rev Med Chile. 2007;135:587–95.PubMed Fritsch R, Araya R, Solis J, Montt ME, Pilowsky D, Rojas G. Ensayo clínico randomizado de farmacoterapia con monitorización telefónica para mejorar el tratamiento de la depresión en la atención primaria en Santiago. Chile Rev Med Chile. 2007;135:587–95.PubMed
37.
go back to reference Corp IBM. IBM SPSS Statistics for Windows, Version 20.0. Armonk, NY: IBM Corp; 2011. Corp IBM. IBM SPSS Statistics for Windows, Version 20.0. Armonk, NY: IBM Corp; 2011.
38.
go back to reference Moher D, Schulz KF, Altman DG. The CONSORT statement: revised recommendations for improving the quality of reports of parallel group randomized trials. Lancet. 2001;357:1191–4.CrossRefPubMed Moher D, Schulz KF, Altman DG. The CONSORT statement: revised recommendations for improving the quality of reports of parallel group randomized trials. Lancet. 2001;357:1191–4.CrossRefPubMed
39.
go back to reference Levav I, Kohn R, Montoya I, Palacio C, Rozic P, Solano I, et al. Training Latin American primary care physicians in the WPA module on depression: results of a multicenter trial. Psychol Med. 2005;35(1):35–45.CrossRefPubMedPubMedCentral Levav I, Kohn R, Montoya I, Palacio C, Rozic P, Solano I, et al. Training Latin American primary care physicians in the WPA module on depression: results of a multicenter trial. Psychol Med. 2005;35(1):35–45.CrossRefPubMedPubMedCentral
Metadata
Title
Comprehensive technology-assisted training and supervision program to enhance depression management in primary care in Santiago, Chile: study protocol for a cluster randomized controlled trial
Authors
Graciela Rojas
Pablo Martínez
Paul A. Vöhringer
Vania Martínez
Ariel Castro-Lara
Rosemarie Fritsch
Publication date
01-12-2015
Publisher
BioMed Central
Published in
Trials / Issue 1/2015
Electronic ISSN: 1745-6215
DOI
https://doi.org/10.1186/s13063-015-0845-4

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