Strengthening Mental Health Care in Chronic Care Patients With Hypertension. A Cluster Randomised Control Trial

Summary

A pragmatic cluster randomized controlled trial (RCT) in 20 public sector primary care clinics in the Dr Kenneth Kaunda district of the North West Province of South Africa to assess mental health and health outcomes for depressed adults receiving hypertensive treatment by measuring the real-world effectiveness of a facility-based stepped care intervention combining stress and depression case detection and management by non-physician clinicians and referral pathways for anti-depressant medication and/or group/individual counselling delivered by lay-health workers for patients with depression. The control condition is enhanced usual primary health care where non-physician clinicians have been equipped with the basic skills to identify stress and depression/anxiety but with limited access to doctors authorized to prescribe antidepressant medication, and with no specific psychosocial interventions.

Conditions

• Depression
• Hypertension

Interventions

BEHAVIORAL

PC101+Mental Health

Facility-based stepped care intervention combining stress and depression case detection and management by non-physician clinicians and referral pathways for anti-depressant medication and/or group/individual counselling delivered by lay-health workers for patients with depression.

Sponsors & Collaborators

• Department for International Development, United Kingdom

  collaborator OTHER_GOV

• University of Cape Town

  collaborator OTHER

• King's College London

  collaborator OTHER

• University of KwaZulu

  lead OTHER

Principal Investigators

• Inge Petersen, PhD · University of KwaZulu

• Lara R Fairall, PhD · University of Cape Town

• Graham Thornicroft, PhD · King's College London

Study Design

Allocation

RANDOMIZED

Purpose

HEALTH_SERVICES_RESEARCH

Masking

SINGLE

Model

PARALLEL

Eligibility

Min Age

18 Years

Max Age

80 Years

Sex

ALL

Healthy Volunteers

No

Timeline & Regulatory

Start

2015-04-22

Primary Completion

2016-10-31

Completion

2017-07-31

Countries

• South Africa