Development and feasibility assessment of a collaborative stepped care intervention for management of depression in the mental health in primary care (MeHPriC) project, Lagos, Nigeria.

Journal: Psychological medicine

Volume: 49

Issue: 13

Year of Publication: 2020

Affiliated Institutions:  Department of Behavioural Medicine, Lagos State University College of Medicine, Ikeja, Lagos, Nigeria. Centre for Mental Health Research and Initiative, Lagos, Nigeria. Department of Psychiatry, Lagos State University Teaching Hospital, Ikeja, Lagos, Nigeria. Lagos State Health Services Commission, Lagos, Nigeria. Federal Neuropsychiatric Hospital, Yaba, Lagos, Nigeria.

Abstract summary 

This study aimed to develop and test the feasibility of a primary care worker-led psychological intervention as the main feature of a collaborative stepped care for depression that is effective, affordable, culturally acceptable, tailored to patients' clinical condition and easily integrate-able into the primary care schedule in Nigeria.Using the Medical Research Council framework, in the first stage (modelling/theoretical development), experts reviewed and distilled evidence from literature to form the intervention components. In the second (formative) stage, local stakeholders were consulted on the practical application and feasibility of the proposed intervention. The third (piloting) stage involved testing for the clinical efficacy and acceptability of the components of the draft intervention.The final intervention components included a 2-stage screening (red-flagging and further evaluation), psychoeducation, low-intensity psychological therapy (problem-solving therapy for primary care), antidepressant prescription, proactive mobile telephony adherence support and referral to the mental health specialist if needed. At 3 months, 71.6% of depressed patients on the intervention improved. The intervention was perceived to be acceptable and useful by over 70% of health workers and clients and had high ratings (>70% score) by expert panels on intervention simplicity, facilitation strategies, and quality of delivery.The development and feasibility testing of our integrated intervention encompassed review of current literature, expert opinions and consultation with local stakeholders and end users. Our intervention package was largely deemed acceptable, relevant, useful, and feasible. Important lessons learnt with this process will help in future intervention developments.

Authors & Co-authors:  Adewuya Abiodun O AO Adewumi Tomilola T Momodu Olufisayo O Olibamoyo Olushola O Adesoji Olabanji O Adegbokun Adedayo A Adeyemo Suraju S Manuwa Olufikunayo O Adegbaju Dapo D

Study Outcome 

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Citations : 
Authors :  9
Identifiers
Doi : 10.1017/S0033291718002970
SSN : 1469-8978
Study Population
Male,Female
Mesh Terms
Adult
Other Terms
Collaborative stepped care;Nigeria;depression;feasibility;primary care
Study Design
Cross Sectional Study
Study Approach
Country of Study
Niger
Publication Country
England