Trial reportBMJ global health2025
Productivity benefits of treatment of depression and post-traumatic stress disorder in Kenya.
Trial report in BMJ global health, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03466346 (A Sequential, Multiple Assignment Randomized Trial), which is not on this map. Cited by 1 paper.
What it found
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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.
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.
A Sequential, Multiple Assignment Randomized Trial (SMART) for Non-specialist Treatment of Common Mental Disorders in Kenya: Leveraging the Depression And Primary-care Partnership for Effectiveness-implementation Research (DAPPER) Project
Who cites it
1 citing paper in PubMed.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
18 authors.
Funding
Abstract
introductionDepression and post-traumatic stress disorder (PTSD) significantly contribute to the global disease burden, adversely affecting health, medical costs and economic productivity. The SMART-DAPPER project in western Kenya approached this challenge by deploying trained non-specialists to administer proven depression and PTSD treatments.
methodsParticipants were public sector primary care outpatients at Kiumu County Hospital with major depression and/or PTSD. They were randomised to first-line treatment with interpersonal psychotherapy (IPT) or fluoxetine. We evaluated three measures of economic productivity: income, absenteeism and presenteeism (lowered work efficiency). Change over baseline and comparisons between treatments were conducted using generalised estimating equations regression.
resultsThere were statistically significant gains in economic productivity from baseline to the end of first-line treatment. The percentage of participants earning a monthly income rose from 54.9% at baseline to 59.8% after treatment in the IPT group and from 54.5% to 61.5% in the Fluoxetine group. Improvement was significantly associated with illness remission. Average monthly income among earners increased by Kenya shillings (KES) 1920 (46 Intl$) with IPT and KES 1350 (31 Intl$) with fluoxetine. Absenteeism dropped in both treatment arms, by 1.5 days per month for IPT and 1.9 days per month for fluoxetine. Presenteeism decreased more with fluoxetine (4.8 days per month) than with IPT (3.3 days per month).
conclusionTreating common mental disorders with IPT and fluoxetine in public sector primary care settings was associated with economic productivity. Leveraging a non-specialist workforce for treatment delivery at scale may build individual and community economic well-being.
fundingR01MH113722(NIMH), R01MH115512(NIMH-GACD). TRIAL REGISTRATION NUMBER: ClinicalTrials.gov Identifier: NCT03466346.
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