Evidence map›Paper›PMID 32429877›Full record

ArticleBMC psychiatry2020

The role of patient-provider communication: a qualitative study of patient attitudes regarding co-occurring depression and chronic diseases in Malawi.

Christopher F Akiba, Chifundo C Zimba, Annie Thom, Maureen Matewere, Vivian Go, Brian Pence, Bradley N Gaynes, Jones Masiye

Registry-linked trialAbstract read
In one paragraph

Article in BMC psychiatry, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03711786 (The Sub-Saharan Africa Regional Partnership), which is not on this map. Cited by 9 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
9citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT03711786 nacompletednot on this map

The Sub-Saharan Africa Regional Partnership (SHARP) for Mental Health Capacity Building

TypeinterventionalSponsorUniversity of North Carolina, Chapel HillRan2019 to 2022Enrolled946ConditionsDepressionArmsBasic implementation package, Enhanced implementation package
3 · Its place in the literature

Who cites it

9 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Christopher F AkibaDepartment of Health Behavior, University of North Carolina at Chapel Hill, Gillings School of Global Public Health, 363 Rosenau Hall, CB# 7440, Chapel Hill, NC, 27599, USA. akiba@live.unc.edu.ORCID 0000-0002-9434-815X
Chifundo C ZimbaUniversity of North Carolina Project Malawi, Tidziwe Center, 100 Mzimba Road, Private Bag A, /104, Lilongwe, Malawi.
Annie ThomUniversity of North Carolina Project Malawi, Tidziwe Center, 100 Mzimba Road, Private Bag A, /104, Lilongwe, Malawi.
Maureen MatewereUniversity of North Carolina Project Malawi, Tidziwe Center, 100 Mzimba Road, Private Bag A, /104, Lilongwe, Malawi.
Vivian GoDepartment of Health Behavior, University of North Carolina at Chapel Hill, Gillings School of Global Public Health, 363 Rosenau Hall, CB# 7440, Chapel Hill, NC, 27599, USA.
Brian PenceDepartment of Epidemiology, University of North Carolina at Chapel Hill, Gillings School of Global Public Health, 2103C McGavran-Greenberg Hall, CB #7435, Chapel Hill, NC, 27599, USA.
Bradley N GaynesDepartment of Psychiatry, University of North Carolina at Chapel Hill, School of Medicine, 101 Manning Drive, Chapel Hill, NC, 27514, USA.
Jones MasiyeMalawi Ministry of Health and Population, Non-communicable Diseases and Mental Health Clinical Services, P.O Box 30377, Lilongwe, 3, Malawi.

Funding

Sub-Saharan Africa Regional Partnership (SHARP) for Mental Health Capacity Building - Scale-Up ComponentU19MH113202 · NIMH · UNIV OF NORTH CAROLINA CHAPEL HILL · PI GO, VIVIAN F. · 2017 to 2021
$4.1M
NIMH NIH HHS U19 MH113202
6 · The paper itself

Abstract

backgroundGlobally, depression is a leading cause of morbidity and mortality particularly in Low and Middle-Income Countries (LMICs). The burden of non-communicable diseases (NCDs) are also increasing in LMICs, the conditions frequently co-occur and exacerbate NCD outcomes. Depression interventions alone are not effective at improving NCD outcomes, resulting in wide-reaching calls for integrated services. Integrated services are in a nascent phase in LMICs in general and in Malawi in particular. This manuscript serves to clarify Malawian patients' attitudes and perceptions towards depression integration into routine NCD services.

methodsTen District Hospitals were selected for data collection and 2 participants were interviewed from each site (N = 20). An iterative approach to concept-driven coding was applied to facilitate the formation of similarities, differences, and connections between codes.

resultsWhile patients infrequently described moderate depression as a medical condition, and held various attitudes regarding treatments, they agreed on the appropriateness of integrated services. Patients' respect for their providers led them to support integration. Patients discussed how medical knowledge is highly regarded, revealing a power dynamic with their providers. Patients further acknowledged the importance of a provider's communication in shaping a patient's feelings about depression.

conclusionsTraining and interventions that facilitate providers' abilities to transfer their medical knowledge, use strategies to channel their power, and engage patients in a meaningful and collaborative relationship will be key to successfully integrating depression treatment into Malawian NCD clinics.

trial registrationThis work served as part of formative data collection for National Institute of Mental Health (NIMH) Trail NCT03711786 registered on 10th October, 2018.

Indexed as

AttitudePhysician-Patient RelationsQualitative ResearchAdultAgedChronic DiseaseDepressionFemaleHumansMalawiMaleMiddle AgedPatientsDepressionIntegrated careInternational healthLow and middle-income countriesMalawiNon-communicable diseasesPatient-provider communication

Identifiers

PMID32429877
PMCPMC7236218

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.