. 2021 Aug 5;16(8):e0255594.

doi: 10.1371/journal.pone.0255594. eCollection 2021.

Primary care-based screening and management of depression amongst heavy drinking patients: Interim secondary outcomes of a three-country quasi-experimental study in Latin America

Amy O'Donnell¹, Bernd Schulte², Jakob Manthey^{2

3

4}, Christiane Sybille Schmidt², Marina Piazza⁵, Ines Bustamante Chavez⁵, Guillermina Natera⁶, Natalia Bautista Aguilar⁶, Graciela Yazmín Sánchez Hernández⁶, Juliana Mejía-Trujillo⁷, Augusto Pérez-Gómez⁷, Antoni Gual^{8

9

10}, Hein de Vries¹¹, Adriana Solovei¹¹, Dasa Kokole¹¹, Eileen Kaner¹, Carolin Kilian³, Jurgen Rehm^{2

3

12

13

14

15}, Peter Anderson^{1

11}, Eva Jané-Llopis^{11

12

16}

Affiliations

¹ Population Health Sciences Institute, Newcastle University, Newcastle Upon Tyne, United Kingdom.
² Center for Interdisciplinary Addiction Research (ZIS), Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
³ Institute for Clinical Psychology and Psychotherapy, TU Dresden, Dresden, Germany.
⁴ Department of Psychiatry, Medical Faculty, University of Leipzig, Leipzig, Germany.
⁵ Mental Health, Alcohol, and Drug Research Unit, School of Public Health and Administration, Universidad Peruana Cayetano Heredia, Lima, Peru.
⁶ Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz, CDMX, Mexico.
⁷ Corporación Nuevos Rumbos, Bogotá, Colombia.
⁸ Addictions Unit, Psychiatry Dept, Hospital Clínic, Barcelona, Spain.
⁹ Red de Trastornos Adictivos, Instituto Carlos III, Madrid, Spain.
¹⁰ Institut d'Investigacions Biomèdiques August Pi Sunyer (IDIBAPS), Barcelona, Spain.
¹¹ Department of Health Promotion, CAPHRI Care and Public Health Research Institute, Maastricht University, Maastricht, The Netherlands.
¹² Institute for Mental Health Policy Research, CAMH, Toronto, Ontario, Canada.
¹³ Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.
¹⁴ Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada.
¹⁵ Department of International Health Projects, Institute for Leadership and Health Management, I.M. Sechenov First Moscow State Medical University, Moscow, Russian Federation.
¹⁶ Univ. Ramon Llull, ESADE, Barcelona, Spain.

PMID: 34352012
PMCID: PMC8341512
DOI: 10.1371/journal.pone.0255594

Primary care-based screening and management of depression amongst heavy drinking patients: Interim secondary outcomes of a three-country quasi-experimental study in Latin America

Amy O'Donnell et al. PLoS One. 2021.

. 2021 Aug 5;16(8):e0255594.

doi: 10.1371/journal.pone.0255594. eCollection 2021.

Authors

Affiliations

¹ Population Health Sciences Institute, Newcastle University, Newcastle Upon Tyne, United Kingdom.
² Center for Interdisciplinary Addiction Research (ZIS), Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
³ Institute for Clinical Psychology and Psychotherapy, TU Dresden, Dresden, Germany.
⁴ Department of Psychiatry, Medical Faculty, University of Leipzig, Leipzig, Germany.
⁵ Mental Health, Alcohol, and Drug Research Unit, School of Public Health and Administration, Universidad Peruana Cayetano Heredia, Lima, Peru.
⁶ Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz, CDMX, Mexico.
⁷ Corporación Nuevos Rumbos, Bogotá, Colombia.
⁸ Addictions Unit, Psychiatry Dept, Hospital Clínic, Barcelona, Spain.
⁹ Red de Trastornos Adictivos, Instituto Carlos III, Madrid, Spain.
¹⁰ Institut d'Investigacions Biomèdiques August Pi Sunyer (IDIBAPS), Barcelona, Spain.
¹¹ Department of Health Promotion, CAPHRI Care and Public Health Research Institute, Maastricht University, Maastricht, The Netherlands.
¹² Institute for Mental Health Policy Research, CAMH, Toronto, Ontario, Canada.
¹³ Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.
¹⁴ Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada.
¹⁵ Department of International Health Projects, Institute for Leadership and Health Management, I.M. Sechenov First Moscow State Medical University, Moscow, Russian Federation.
¹⁶ Univ. Ramon Llull, ESADE, Barcelona, Spain.

PMID: 34352012
PMCID: PMC8341512
DOI: 10.1371/journal.pone.0255594

Abstract

Introduction: Implementation of evidence-based care for heavy drinking and depression remains low in global health systems. We tested the impact of providing community support, training, and clinical packages of varied intensity on depression screening and management for heavy drinking patients in Latin American primary healthcare.

Materials and methods: Quasi-experimental study involving 58 primary healthcare units in Colombia, Mexico and Peru randomized to receive: (1) usual care (control); (2) training using a brief clinical package; (3) community support plus training using a brief clinical package; (4) community support plus training using a standard clinical package. Outcomes were proportion of: (1) heavy drinking patients screened for depression; (2) screen-positive patients receiving appropriate support; (3) all consulting patients screened for depression, irrespective of drinking status.

Results: 550/615 identified heavy drinkers were screened for depression (89.4%). 147/230 patients screening positive for depression received appropriate support (64%). Amongst identified heavy drinkers, adjusting for country, sex, age and provider profession, provision of community support and training had no impact on depression activity rates. Intensity of clinical package also did not affect delivery rates, with comparable performance for brief and standard versions. However, amongst all consulting patients, training providers resulted in significantly higher rates of alcohol measurement and in turn higher depression screening rates; 2.7 times higher compared to those not trained.

Conclusions: Training using a brief clinical package increased depression screening rates in Latin American primary healthcare. It is not possible to determine the effectiveness of community support on depression activity rates due to the impact of COVID-19.

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Conflict of interest statement

The authors have declared that no competing interests exist.

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Kokole D, Jané-Llopis E, Natera Rey G, Aguilar NB, Medina Aguilar PS, Mejía-Trujillo J, Mora K, Restrepo N, Bustamante I, Piazza M, O'Donnell A, Solovei A, Mercken L, Schmidt CS, Lopez-Pelayo H, Matrai S, Braddick F, Gual A, Rehm J, Anderson P, de Vries H. Kokole D, et al. Implement Res Pract. 2022 Jul 15;3:26334895221112693. doi: 10.1177/26334895221112693. eCollection 2022 Jan-Dec. Implement Res Pract. 2022. PMID: 37091075 Free PMC article.
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References

1. Liu Q, He H, Yang J, Feng X, Zhao F, Lyu J. Changes in the global burden of depression from 1990 to 2017: Findings from the Global Burden of Disease study. Journal of Psychiatric Research. 2020;126:134–40. doi: 10.1016/j.jpsychires.2019.08.002 - DOI - PubMed
1. Cuijpers P, Smit F. Excess mortality in depression: a meta-analysis of community studies. Journal of affective disorders. 2002;72(3):227–36. doi: 10.1016/s0165-0327(01)00413-x - DOI - PubMed
1. Cuijpers P, Vogelzangs N, Twisk J, Kleiboer A, Li J, Penninx BW. Comprehensive meta-analysis of excess mortality in depression in the general community versus patients with specific illnesses. Am J Psychiatry. 2014;171(4):453–62. doi: 10.1176/appi.ajp.2013.13030325 - DOI - PubMed
1. Ferrari AJ, Norman RE, Freedman G, Baxter AJ, Pirkis JE, Harris MG, et al.. The burden attributable to mental and substance use disorders as risk factors for suicide: findings from the Global Burden of Disease Study 2010. PLoS One. 2014;9(4):e91936. doi: 10.1371/journal.pone.0091936 - DOI - PMC - PubMed
1. Egede LE. Major depression in individuals with chronic medical disorders: prevalence, correlates and association with health resource utilization, lost productivity and functional disability. General hospital psychiatry. 2007;29(5):409–16. doi: 10.1016/j.genhosppsych.2007.06.002 - DOI - PubMed

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Primary care-based screening and management of depression amongst heavy drinking patients: Interim secondary outcomes of a three-country quasi-experimental study in Latin America

Affiliations

Primary care-based screening and management of depression amongst heavy drinking patients: Interim secondary outcomes of a three-country quasi-experimental study in Latin America

Authors

Affiliations

Abstract

Conflict of interest statement

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Medical