Sustained effectiveness and cost-effectiveness of the Healthy Activity Programme, a brief psychological treatment for depression delivered by lay counsellors in primary care: 12-month follow-up of a randomised controlled trial

PLoS Medicine

Volumn 14, Issue 9, 2017, Pages

  Weobong, Benedict ^a,e   Weiss, Helen A ^a   McDaid, David ^b   Singla, Daisy R ^c   Hollon, Steven D ^d   Nadkarni, Abhijit ^a,e   Park, A La ^b   Bhat, Bhargav ^e   Katti, Basavraj ^e   Anand, Arpita ^e   Dimidjian, Sona ^f   Araya, Ricardo ^a,g   King, Michael ^h   Vijayakumar, Lakshmi ⁱ   Wilson, G Terence ^j   Velleman, Richard ^e,k   Kirkwood, Betty R ^a   Fairburn, Christopher G ^l   Patel, Vikram ^a,e,m  

^a LONDON SCHOOL OF HYGIENE AND TROPICAL MEDICINE   (United Kingdom)

^b LONDON SCHOOL OF ECONOMICS   (United Kingdom)

^c Women s College Hospital   (Canada)

^d VANDERBILT UNIVERSITY   (United States)

^e Sangath   (India)

^f UNIVERSITY OF COLORADO   (United States)

^g KING'S COLLEGE HOSPITAL NHS FOUNDATION TRUST   (United Kingdom)

^h UNIVERSITY COLLEGE LONDON   (United Kingdom)

ⁱ UNIVERSITY OF MELBOURNE   (Australia)

^j RUTGERS UNIVERSITY   (United States)

^k University of Bath   (United Kingdom)

^l UNIVERSITY OF OXFORD   (United Kingdom)

^m HARVARD MEDICAL SCHOOL   (United States)

more..

Author keywords

[No Author keywords available]

Indexed keywords

ADULT; ARTICLE; BECK DEPRESSION INVENTORY; CLINICAL OUTCOME; COST EFFECTIVENESS ANALYSIS; DEPRESSION; DISEASE SEVERITY; DRINKING BEHAVIOR; FEMALE; FOLLOW UP; HUMAN; HUMAN EXPERIMENT; INDIA; MAJOR CLINICAL STUDY; MALE; MENTAL HEALTH CARE; MINIMAL CLINICALLY IMPORTANT DIFFERENCE; MULTICENTER STUDY; PATIENT HEALTH QUESTIONNAIRE 9; PROBLEM SOLVING; PSYCHOLOGICAL DISTRESS ASSESSMENT; RANDOMIZED CONTROLLED TRIAL; RELAPSE; SENSITIVITY ANALYSIS; SOCIAL NETWORK; SUICIDAL BEHAVIOR; TREATMENT OUTCOME; ADOLESCENT; AGED; CLINICAL TRIAL; CONTROLLED STUDY; COST BENEFIT ANALYSIS; DEPRESSIVE DISORDER, MAJOR; ECONOMICS; HEALTH CARE DELIVERY; HEALTH PROMOTION; MIDDLE AGED; PRIMARY HEALTH CARE; PROCEDURES; PSYCHOLOGICAL RATING SCALE; PSYCHOTHERAPY; STATISTICS AND NUMERICAL DATA; YOUNG ADULT;

ADOLESCENT; ADULT; AGED; COST-BENEFIT ANALYSIS; DELIVERY OF HEALTH CARE; DEPRESSIVE DISORDER, MAJOR; FEMALE; FOLLOW-UP STUDIES; HEALTH PROMOTION; HUMANS; INDIA; MALE; MIDDLE AGED; PRIMARY HEALTH CARE; PSYCHIATRIC STATUS RATING SCALES; PSYCHOTHERAPY; TREATMENT OUTCOME; YOUNG ADULT;

EID: 85029713155     PISSN: 15491277     EISSN: 15491676     Source Type: Journal    
DOI: 10.1371/journal.pmed.1002385     Document Type: Article

References (57)

1. Patel V, Chisholm D, Parikh R, Charlson FJ, Degenhardt L, Dua T, et al. Addressing the burden of mental, neurological, and substance use disorders: key messages from Disease Control Priorities, 3rd edition. Lancet. 2016;387(10028):1672–85. doi: 10.1016/S0140-6736(15)00390-6 26454360
2. Whiteford HA, Ferrari AJ, Degenhardt L, Feigin V, Vos T, The global burden of mental, neurological and substance use disorders: an analysis from the Global Burden of Disease Study 2010. PLoS ONE. 2015;10(2):e0116820. doi: 10.1371/journal.pone.0116820 25658103
3. Chisholm D, Sweeny K, Sheehan P, Rasmussen B, Smit F, Cuijpers P, et al. Scaling-up treatment of depression and anxiety: a global return on investment analysis. Lancet Psychiatry. 2016;3(5):415–24. doi: 10.1016/S2215-0366(16)30024-4 27083119
4. Gururaj G, Varghese M, Benegal V, Rao G, Pathak K, Singh L, et al. National Mental Health Survey of India, 2015–16: summary. Bengaluru: National Institute of Mental Health and Neurosciences; 2016. NIMHANS Publication No. 128.
5. World Health OrganizationmhGAP Mental Health Gap Action Programme: scaling up care for mental, neurological and substance use disorders. Geneva: World Health Organization; 2008.
6. Cuijpers P, Hollon SD, van Straten A, Bockting C, Berking M, Andersson G, Does cognitive behaviour therapy have an enduring effect that is superior to keeping patients on continuation pharmacotherapy? A meta-analysis. BMJ Open. 2013;3(4):e002542. doi: 10.1136/bmjopen-2012-002542 23624992
7. Maziak W, Eissenberg T, Klesges RC, Keil U, Ward KD, Adapting smoking cessation interventions for developing countries: a model for the Middle East. Int J Tuberc Lung Dis. 2004;8(4):403–13. 15141730
8. Patel V, The need for treatment evidence for common mental disorders in developing countries. Psychol Med. 2000;30(4):743–6. 11037082
9. van Ginneken N, Tharyan P, Lewin S, Rao GN, Meera SM, Pian J, et al. Non-specialist health worker interventions for the care of mental, neurological and substance-abuse disorders in low- and middle-income countries. Cochrane Database Syst Rev. 2013;2013(11):CD009149.
10. Singla DR, Kohrt BA, Murray LK, Anand A, Chorpita BC, Patel V, Psychological treatments for the world: lessons from low- and middle-income countries. Annu Rev Clin Psychol. 2017;13:149–181. doi: 10.1146/annurev-clinpsy-032816-045217 28482687
11. Chibanda D, Weiss HA, Verhey R, Simms V, Munjoma R, Rusakaniko S, et al. Effect of a primary care-based psychological intervention on symptoms of common mental disorders in Zimbabwe: a randomized clinical trial. JAMA. 2016;316(24):2618–26. doi: 10.1001/jama.2016.19102 28027368
12. Nadkarni A, Velleman R, Dabholkar H, Shinde S, Bhat B, McCambridge J, et al. The systematic development and pilot randomized evaluation of counselling for alcohol problems, a lay counselor-delivered psychological treatment for harmful drinking in primary care in India: the PREMIUM study. Alcohol Clin Exp Res. 2015;39(3):522–31. doi: 10.1111/acer.12653 25704494
13. Chowdhary N, Anand A, Dimidjian S, Shinde S, Weobong B, Balaji M, et al. The Healthy Activity Program lay counsellor delivered treatment for severe depression in India: systematic development and randomised evaluation. Br J Psychiatry. 2016;208(4):381–8. doi: 10.1192/bjp.bp.114.161075 26494875
14. Vellakkal S, Patel V, Designing psychological treatments for scalability: the PREMIUM approach. PLoS ONE. 2015;10(7):e0134189. doi: 10.1371/journal.pone.0134189 26225853
15. Dimidjian S, Barrera M, JrMartell C, Muñoz RF, Lewinsohn PM, The origins and current status of behavioral activation treatments for depression. Annu Rev Clin Psychol. 2011;7:1–38. doi: 10.1146/annurev-clinpsy-032210-104535 21275642
16. Patel V, Weobong B, Weiss HA, Anand A, Bhat B, Katti B, et al. The Healthy Activity Program (HAP), a lay counsellor-delivered brief psychological treatment for severe depression, in primary care in India: a randomised controlled trial. Lancet. 2017;389(10065):176–85. doi: 10.1016/S0140-6736(16)31589-6 27988143
17. Patel V, Weobong B, Nadkarni A, Weiss H, Anand A, Naik S, et al. The effectiveness and cost-effectiveness of lay counsellor-delivered psychological treatments for harmful and dependent drinking and moderate to severe depression in primary care in India: PREMIUM study protocol for randomized controlled trials. Trials. 2014;15(1):101.
18. Fournier JC, DeRubeis RJ, Shelton RC, Hollon SD, Amsterdam JD, Gallop R, Prediction of response to medication and cognitive therapy in the treatment of moderate to severe depression. J Consult Clin Psychol. 2009;77(4):775–87. doi: 10.1037/a0015401 19634969
19. Schulz KF, Grimes DA, Allocation concealment in randomised trials: defending against deciphering. Lancet. 2002;359(9306):614–8. doi: 10.1016/S0140-6736(02)07750-4 11867132
20. World Health OrganizationmhGAP intervention guide for mental, neurological and substance use disorders in non-specialized health settings. Geneva: World Health Organization; 2010.
21. Singla DR, Weobong B, Nadkarni A, Chowdhary N, Shinde S, Anand A, et al. Improving the scalability of psychological treatments in developing countries: an evaluation of peer-led therapy quality assessment in Goa, India. Behav Res Ther. 2014;60:53–9. doi: 10.1016/j.brat.2014.06.006 25064211
22. Cuijpers P, Karyotaki E, Weitz E, Andersson G, Hollon SD, van Straten A, The effects of psychotherapies for major depression in adults on remission, recovery and improvement: a meta-analysis. J Affect Disord. 2014;159:118–26. doi: 10.1016/j.jad.2014.02.026 24679399
23. Rush AJ, Kraemer HC, Sackeim HA, Fava M, Trivedi MH, Frank E, et al. Report by the ACNP Task Force on response and remission in major depressive disorder. Neuropsychopharmacology. 2006;31(9):1841–53. doi: 10.1038/sj.npp.1301131 16794566
24. McGlothlin AE, Lewis RJ, Minimal clinically important difference: defining what really matters to patients. JAMA. 2014;312(13):1342–3. doi: 10.1001/jama.2014.13128 25268441
25. Button KS, Kounali D, Thomas L, Wiles NJ, Peters TJ, Welton NJ, et al. Minimal clinically important difference on the Beck Depression Inventory—II according to the patient’s perspective. Psychol Med. 2015;45(15):3269–79. doi: 10.1017/S0033291715001270 26165748
26. Jaeschke R, Singer J, Guyatt GH, Measurement of health status. Ascertaining the minimal clinically important difference. Control Clin Trials. 1989;10(4):407–15. 2691207
27. Manos RC, Kanter JW, Luo W, The behavioral activation for depression scale-short form: development and validation. Behav Ther. 2011;42(4):726–39. doi: 10.1016/j.beth.2011.04.004 22036000
28. Kumar GS, Jain A, Hegde S, Prevalence of depression and its associated factors using Beck Depression Inventory among students of a medical college in Karnataka. Indian J Psychiatry. 2012;54(3):223–6. doi: 10.4103/0019-5545.102412 23226844
29. Patel V, Araya R, Chowdhary N, King M, Kirkwood B, Nayak S, et al. Detecting common mental disorders in primary care in India: a comparison of five screening questionnaires. Psychol Med. 2008;38(2):221–8. doi: 10.1017/S0033291707002334 18047768
30. Patel V, Weiss HA, Chowdhary N, Naik S, Pednekar S, Chatterjee S, et al. Effectiveness of an intervention led by lay health counsellors for depressive and anxiety disorders in primary care in Goa, India (MANAS): a cluster randomised controlled trial. Lancet. 2010;376(9758):2086–95. doi: 10.1016/S0140-6736(10)61508-5 21159375
31. Patel V, Chisholm D, Kirkwood BR, Mabey D, Prioritizing health problems in women in developing countries: comparing the financial burden of reproductive tract infections, anaemia and depressive disorders in a community survey in India. Trop Med Int Health. 2007;12(1):130–9. doi: 10.1111/j.1365-3156.2006.01756.x 17207157
32. Patel V, Chisholm D, Rabe-Hesketh S, Dias-Saxena F, Andrew G, Mann A, Efficacy and cost-effectiveness of drug and psychological treatments for common mental disorders in general health care in Goa, India: a randomised, controlled trial. Lancet. 2003;361(9351):33–9. doi: 10.1016/S0140-6736(03)12119-8 12517464
33. Chisholm D, Sekar K, Kumar KK, Saeed K, James S, Mubbashar M, et al. Integration of mental health care into primary care. Demonstration cost-outcome study in India and Pakistan. Br J Psychiatry. 2000;176:581–8. 10974966
34. Maselko J, Patel V, Why women attempt suicide: the role of mental illness and social disadvantage in a community cohort study in India. J Epidemiol Community Health. 2008;62(9):817–22. doi: 10.1136/jech.2007.069351 18701733
35. Localio AR, Margolis DJ, Berlin JA, Relative risks and confidence intervals were easily computed indirectly from multivariable logistic regression. J Clin Epidemiol. 2007;60(9):874–82. doi: 10.1016/j.jclinepi.2006.12.001 17689803
36. Sterne JA, Davey Smith G, Sifting the evidence—what’s wrong with significance tests?BMJ. 2001;322(7280):226–31. 11159626
37. Mackinnon DP, Lockwood CM, Williams J, Confidence limits for the indirect effect: distribution of the product and resampling methods. Multivariate Behav Res. 2004;39(1):99. doi: 10.1207/s15327906mbr3901_4 20157642
38. MacKinnon DP, Fairchild AJ, Fritz MS, Mediation analysis. Annu Rev Psychol. 2007;58:593–614. doi: 10.1146/annurev.psych.58.110405.085542 16968208
39. Preacher KJ, Selig JP, Advantages of Monte Carlo confidence intervals for indirect effects. Commun Methods Meas. 2012;6(2):77–98.
40. Buttorff C, Hock RS, Weiss HA, Naik S, Araya R, Kirkwood BR, et al. Economic evaluation of a task-shifting intervention for common mental disorders in India. Bull World Health Organ. 2012;90(11):813–21. doi: 10.2471/BLT.12.104133 23226893
41. Kessler RC, Barber C, Birnbaum HG, Frank RG, Greenberg PE, Rose RM, et al. Depression in the workplace: effects on short-term disability. Health Aff (Millwood). 1999;18(5):163–71.
42. Hutubessy R, Chisholm D, Edejer TT, Generalized cost-effectiveness analysis for national-level priority-setting in the health sector. Cost Eff Resour Alloc. 2003;1(1):8. doi: 10.1186/1478-7547-1-8 14687420
43. Ministry of Statistics and Programme Implementation. State Domestic Product and other aggregates, 2011–12 series. 2016 [cited 2017 Aug 11]. Available from: http://mospi.nic.in/data.
44. Dobson KS, Hollon SD, Dimidjian S, Schmaling KB, Kohlenberg RJ, Gallop RJ, et al. Randomized trial of behavioral activation, cognitive therapy, and antidepressant medication in the prevention of relapse and recurrence in major depression. J Consult Clin Psychol. 2008;76(3):468–77. doi: 10.1037/0022-006X.76.3.468 18540740
45. Levinson D, Lakoma MD, Petukhova M, Schoenbaum M, Zaslavsky AM, Angermeyer M, et al. Associations of serious mental illness with earnings: results from the WHO World Mental Health surveys. Br J Psychiatry. 2010;197(2):114–21. doi: 10.1192/bjp.bp.109.073635 20679263
46. Layard R, Clark DM, Thrive: the power of evidence-based psychological therapies. London: Penguin Books; 2014.
47. Dimidjian S, Goodman SH, Sherwood NE, Simon GE, Ludman E, Gallop R, et al. A pragmatic randomized clinical trial of behavioral activation for depressed pregnant women. J Consult Clin Psychol. 2017;85(1):26–36. doi: 10.1037/ccp0000151 28045285
48. Ryba MM, Lejuez CW, Hopko DR, Behavioral activation for depressed breast cancer patients: the impact of therapeutic compliance and quantity of activities completed on symptom reduction. J Consult Clin Psychol. 2014;82(2):325–35. doi: 10.1037/a0035363 24364801
49. DeRubeis RJ, Hollon SD, Amsterdam JD, Shelton RC, Young PR, Salomon RM, et al. Cognitive therapy vs medications in the treatment of moderate to severe depression. Arch Gen Psychiatry. 2005;62(4):409–16. doi: 10.1001/archpsyc.62.4.409 15809408
50. Dimidjian S, Hollon SD, Dobson KS, Schmaling KB, Kohlenberg RJ, Addis ME, et al. Randomized trial of behavioral activation, cognitive therapy, and antidepressant medication in the acute treatment of adults with major depression. J Consult Clin Psychol. 2006;74(4):658–70. doi: 10.1037/0022-006X.74.4.658 16881773
51. Möller HJ, Riedel M, Seemüller F, Relapse or recurrence in depression: why has the cutoff been set at 6 months?Medicographia. 2011;33(2):125–31.
52. Imai K, Keele L, Tingley D, A general approach to causal mediation analysis. Psychol Methods. 2010;15(4):309–34. doi: 10.1037/a0020761 20954780
53. MacKinnon DP, Pirlott AG, Statistical approaches for enhancing causal interpretation of the M to Y relation in mediation analysis. Pers Soc Psychol Rev. 2015;19(1):30–43. doi: 10.1177/1088868314542878 25063043
54. Wiles N, Lewis G, Peters T, Kuyken W, Williams C, Cognitive behavioural therapy for treatment-resistant depression—authors’ reply. Lancet. 2013;381(9880):1814–5.
55. Rahman A, Hamdani SU, Awan NR, Bryant RA, Dawson KS, Khan MF, et al. Effect of a multicomponent behavioral intervention in adults impaired by psychological distress in a conflict-affected area of Pakistan: a randomized clinical trial. JAMA. 2016;316(24):2609–17. doi: 10.1001/jama.2016.17165 27837602
56. Nadkarni A, Weiss AH, Weobong B, McDaid D, Singla DR, Park A-L, et al. Sustained effectiveness and cost-effectiveness of Counselling for Alcohol Problems, a brief psychological treatment for harmful drinking in men, delivered by lay counsellors in primary care: 12-month follow-up of a randomised controlled trial. PLoS Med. 2017;14:e1002386. doi: 10.1371.journal.pmed.1002386
57. Lei H, Nahum-Shani I, Lynch K, Oslin D, Murphy SA, A “SMART” design for building individualized treatment sequences. Annu Rev Clin Psychol. 2012;8:21–48. doi: 10.1146/annurev-clinpsy-032511-143152 22224838