ArticleBMC psychiatry2019
Evaluation of a collaborative care model for integrated primary care of common mental disorders comorbid with chronic conditions in South Africa.
Article in BMC psychiatry, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 47 papers, 4 of them syntheses that pooled it.
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Who cites it
47 citing papers in PubMed, 4 syntheses or guidelines pooled it, 82 citations in OpenAlex.
- Global evidence on the effectiveness of task-shifting and task-sharing strategies for managing individuals with multimorbidity: systematic review and meta-analysis.Family medicine and community health · 2025Pooled it
- Interventions to improve the detection of depression in primary healthcare: systematic review.Systematic reviews · 2023Pooled it
- Primary care team and its association with quality of care for people with multimorbidity: a systematic review.BMC primary care · 2023Pooled it
- The Effectiveness of Patient-Centred Medical Home-Based Models of Care versus Standard Primary Care in Chronic Disease Management: A Systematic Review and Meta-Analysis of Randomised and Non-Randomised Controlled Trials.International journal of environmental research and public health · 2020Pooled it
- Fuzzy-set qualitative comparative analysis of implementation outcomes in an integrated mental healthcare trial in South Africa.Global health action · 2021Trial
- Article
- Service providers' perspectives on strategies to reduce caregiver burden among informal carers of people living with mental health conditions in rural South Africa: A qualitative descriptive study.PLOS global public health · 2026Article
- Recognition of depression by nurses in primary healthcare in Zimbabwe: Cross-sectional study.Global mental health (Cambridge, England) · 2026Article
- Charting neuroethics discourse in Africa: A scoping review of ethical issues of neuroscience research in Africa.IBRO neuroscience reports · 2025Article
- Understanding the role and organization of health workers delivering non-communicable disease management in primary care in low- and middle-income countries: a scoping review.BMC primary care · 2025Article
- Barriers and Facilitators to Implementation of Mental Health Task Sharing Among Older Chinese Adults: A Qualitative Study.Administration and policy in mental health · 2025Article
- Acceptability and feasibility of a task-shifted collaborative care model for depression and anxiety in primary HIV clinics in the Philippines: a qualitative inquiry.BMC health services research · 2025Article
- 'The community lives on sleeping medication and antidepressant[s]….': Health care workers' experiences of mental health service provision in rural South Africa.PLOS mental health · 2025Article
- Implementation of Primary Psychological Healthcare Policy to Address the Risk of Depression in Underprivileged Children and Adolescents, in the Entire Lower-Middle-Economic-Status City of China: An Observational, Multicenter, and Single-Arm Cohort Study.Depression and anxiety · 2025Observational
- Article
- People with Multiple Long-Term Health Problems: Personalized Care Planning.Portuguese journal of public health · 2024Review
- Collaborative implementation of an evidence-based package of integrated primary mental healthcare using quality improvement within a learning health systems approach: Lessons from the Mental health INTegration programme in South Africa.Learning health systems · 2024Article
- Predictors of Physician Follow-Up Care Among Patients Affected by an Incident Mental Disorder Episode in Quebec (Canada).Canadian journal of psychiatry. Revue canadienne de psychiatrie · 2024Observational
- Views held by South African primary health care nurses on caring for people living with mental illness.The South African journal of psychiatry : SAJP : the journal of the Society of Psychiatrists of South Africa · 2024Article
- Role and knowledge of nurses in the management of non-communicable diseases in Africa: A scoping review.PloS one · 2024Article
Corrections and comments
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Authors and funding
8 authors at 3 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe rise in multimorbid chronic conditions in South Africa, large treatment gap for common mental disorders (CMDs) and shortage of mental health specialists demands a task sharing approach to chronic disease management that includes treatment for co-existing CMDs to improve health outcomes. The aim of this study was thus to evaluate a task shared integrated collaborative care package of care for chronic patients with co-existing depressive and alcohol use disorder (AUD) symptoms.
methodsThe complex intervention strengthened capacity of primary care nurse practitioners to identify, diagnose and review symptoms of CMDs among chronic care patients; and implemented a stepped up referral system, that included clinic-based psychosocial lay counsellors, doctors and mental health specialists. Under real world conditions, in four PHC facilities, a repeat cross-sectional Facility Detection Survey (FDS) assessed changes in capacity of nurses to correctly detect CMDs in 1310 patients before implementation and 1246 patients following implementation of the intervention at 12 months; and a non-randomly assigned comparison group cohort study comprising 373 screen positive patients with depressive symptoms using the Patient Health Questionnaire-9 (PHQ9) at baseline, evaluated responses of patients correctly identified and referred for treatment (intervention arm) or not identified and referred (control arm) at three and 12 months.
resultsThe FDS showed a significant increase in the identification of depression and AUD from pre-implementation to 12-month post-implementation. Depression: (5.8 to 16.4%) 95% CI [2.9, 19.1]); AUD: (0 to 13.8%) 95% CI [0.6-24.9]. In the comparison group cohort study, patients with depressive symptoms having more than a 50% reduction in PHQ-9 scores were greater in the treatment group (n = 69, 55.2%) compared to the comparison group (n = 49, 23.4%) at 3 months (RR = 2.10, p < 0.001); and 12 months follow-up (intervention: n = 57, 47.9%; comparison: n = 60, 30.8%; RR = 1.52, p = 0.006). Remission (PHQ-9 ≤ 5) was greater in the intervention group (n = 32, 26.9%) than comparison group (n = 33, 16.9%) at 12 months (RR = 1.72, p = 0.016).
conclusionA task shared collaborative stepped care model can improve detection of CMDs and reduce depressive symptoms among patients with chronic conditions under real world conditions.
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