ArticleInternational journal of psychiatry in medicine2012
Feasibility of nurse-led antidepressant medication management of depression in an HIV clinic in Tanzania.
Article in International journal of psychiatry in medicine, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 25 papers, 6 of them syntheses that pooled it.
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Who cites it
25 citing papers in PubMed, 6 syntheses or guidelines pooled it.
- How primary healthcare workers obtain information during consultations to aid safe prescribing in low-income and lower middle-income countries: a systematic review.BMJ global health · 2020Pooled it
- Assessment of Barriers and Facilitators to the Delivery of Care for Noncommunicable Diseases by Nonphysician Health Workers in Low- and Middle-Income Countries: A Systematic Review and Qualitative Analysis.JAMA network open · 2019Pooled it
- Systematic Review of Interventions for Depression for People Living with HIV in Africa.AIDS and behavior · 2018Pooled it
- Interventions and approaches to integrating HIV and mental health services: a systematic review.Health policy and planning · 2017Pooled it
- Health systems facilitators and barriers to the integration of HIV and chronic disease services: a systematic review.Health policy and planning · 2017Pooled it
- Task shifting for non-communicable disease management in low and middle income countries--a systematic review.PloS one · 2014Pooled it
- Integrating depression management into HIV primary care in central Malawi: the implementation of a pilot capacity building program.BMC health services research · 2018Trial
- Trial
- Barriers and potential solutions for effective integration of depression care into non-communicable diseases clinics in Malawi: a qualitative end-point evaluation of the SHARP randomized controlled trial.International journal of mental health systems · 2025Article
- Integration of mental health and HIV service delivery in low- and middle-income countries: A systematic review of effectiveness.Global mental health (Cambridge, England) · 2025Review
- Acceptability of a Randomized Trial of Anti-depressant Medication or Interpersonal Therapy for Treatment of Perinatal Depression in Women with HIV.AIDS and behavior · 2024Article
- Role and knowledge of nurses in the management of non-communicable diseases in Africa: A scoping review.PloS one · 2024Article
- Availability of screening and treatment for common mental disorders in HIV clinic settings: data from the global International epidemiology Databases to Evaluate AIDS (IeDEA) Consortium, 2016-2017 and 2020.Journal of the International AIDS Society · 2023Article
- Mapping the effectiveness of integrating mental health in HIV programs: a scoping review.BMC health services research · 2023Article
- The acceptability of antidepressant treatment in people living with HIV in Malawi: A patient perspective.Global public health · 2023Article
- Availability of two essential medicines for mental health in Bangladesh, the Democratic Republic of Congo, Haiti, Nepal, Malawi, Senegal, and Tanzania: Evidence from nationally representative samples of 7958 health facilities.Journal of global health · 2022Article
- A Mixed-Methods Process Evaluation: Integrating Depression Treatment Into HIV Care in Malawi.Global health, science and practice · 2021Article
- Stakeholders' perspectives on integrating the management of depression into routine HIV care in Uganda: qualitative findings from a feasibility study.International journal of mental health systems · 2021Article
- Article
- Implementation outcomes and strategies for depression interventions in low- and middle-income countries: a systematic review.Global mental health (Cambridge, England) · 2020Review
Corrections and comments
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Authors and funding
5 authors.
Funding
Abstract
objectiveSub-Saharan Africa has the highest HIV prevalence worldwide and depression is highly prevalent among those infected. The negative impact of depression on HIV outcomes highlights the need to identify and treat it in this population. A model for doing this in lower-resourced settings involves task-shifting depression treatment to primary care; however, HIV-infected individuals are often treated in a parallel HIV specialty setting. We adapted a model of task-shifting, measurement-based care (MBC), for an HIV clinic setting and tested its feasibility in Tanzania. MBC involves measuring depressive symptoms at meaningful intervals and adjusting antidepressant medication treatment based on the measure of illness.
methodTwenty adults presenting for care at an outpatient HIV clinic in Tanzania were enrolled and followed by a nurse care manager who measured depressive symptoms at baseline and every 4 weeks for 12 weeks. An algorithm-based decision-support tool was utilized by the care manager to recommend individualized antidepressant medication doses to participants' HIV providers at each visit.
resultsRetention was high and fidelity of the care manager to the MBC protocol was exceptional. Follow through of antidepressant prescription dosing recommendations by the prescriber was low. Limited availability of antidepressants was also noted. Despite challenges, baseline depression scores decreased over the 12-week period.
conclusionsOverall, the model of algorithm-based nursing support of prescription decisions was feasible. Future studies should address implementation issues of medication supply and dosing. Further task-shifting to relatively more abundant and lower-skilled health workers, such as nurses' aides, warrants examination.
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