Cluster randomised controlled trial for late life depression in socioeconomically deprived areas of São Paulo, Brazil

• Processo: 13/50953-4
• Modalidade de apoio: Auxílio à Pesquisa - Temático
• Vigência: 01 de março de 2015 - 28 de fevereiro de 2017
• Área do conhecimento: Ciências da Saúde - Medicina - Psiquiatria
• Convênio/Acordo: MRC, UKRI
• Pesquisador responsável: Marcia Scazufca
• Beneficiário: Marcia Scazufca
• Pesq. responsável no exterior: Ricardo Araya
• Instituição no exterior: London School of Hygiene and Tropical Medicine, Inglaterra
• Instituição Sede: Faculdade de Medicina (FM). Universidade de São Paulo (USP). São Paulo , SP, Brasil
• Bolsa(s) vinculada(s): 15/10682-7 - Ensaio clínico controlado e randomizado por agrupamento para depressão em idosos residentes em áreas socioeconomicamente desfavorecidas de São Paulo, Brasil: estudo piloto, BP.PD; 15/00648-6 - Ensaio clínico controlado e randomizado por agrupamento para depressão em idosos residentes em áreas socioeconomicamente desfavorecidas de São Paulo, Brasil: estudo piloto, BP.PD
• Assunto(s): Depressão Velhice População de baixa renda Impacto psicossocial
• Palavra(s)-Chave do Pesquisador: Psiquiatria
• Publicação FAPESP: https://media.fapesp.br/bv/uploads/pdfs/fapesp_uk_vWFayNU_108_109.pdf

Resumo

This proposal aims to estimate to what extent adding to usual care a psychosocial, community-based intervention managed mostly delivered by nurse assistants (NA) and integrated within the existing primary care system improves depression recovery rates and functioning among depressed older adults from poor socioeconomic background in São Paulo, Brazil. This will be a two-arm cluster randomised controlled trial involving 1,280 participants registered with 20 Family Health Units (clusters). Those in the intervention arm will receive a psychosocial intervention and improved case management led by a NA based in primary care. The intervention will be mostly delivered at home and will last 8 months. NAs will be supported with tablet computers to deliver the intervention, and to receive further training, supervision and ongoing support. NA acting as case managers will liaise closely with the primary care team to ensure the best care is received by those suffering from depression (collaborative care). Those participants who do not improve with the intervention will be discussed in regular team meetings and further clinical decisions decided, if needed. The control group will receive 'enhanced' usual care alone in so far as cases being identified and the team will receive training in the management of depression at the start of the trial. We will compare the recovery of cases (PHQ-9 total scores <5) across arms at 4 and 9 months after entering the trial using an intention-to-treat analysis. We will also assess functioning and quality of life. Direct and indirect costs in both arms will be measured to undertake a cost-effectiveness analysis. (AU)

Publicações científicas

(Referências obtidas automaticamente do Web of Science e do SciELO, por meio da informação sobre o financiamento pela FAPESP e o número do processo correspondente, incluída na publicação pelos autores)

VAN DE VEN, PEPIJN; ARAYA, RICARDO; COUTO, MARIA CLARA P. DE PAULA; HENRIQUE, MAIARA GARCIA; MEERE, DAMIEN; MENDES, ANA VILELA; PETERS, TIM J.; SEABRA, ANTONIO; FRANZIN, RENATO M.; PEREDA, PAULA CARVALHO; et al. Investigating Software Requirements for Systems Supporting Task-Shifted Interventions: Usability Study. JOURNAL OF MEDICAL INTERNET RESEARCH, v. 21, n. 11, NOV 12 2019. (13/50953-4)

SCAZUFCA, MARCIA; DE PAULA COUTO, MARIA CLARA P.; HENRIQUE, MAIARA GARCIA; MENDES, ANA VILELA; MATIJASEVICH, ALICIA; PEREDA, PAULA CARVALHO; FRANZIN, RENATO M.; SEABRA, ANTONIO CARLOS; VAN DE VEN, PEPIJN; HOLLINGWORTH, WILLIAM; et al. Pilot study of a two-arm non-randomized controlled cluster trial of a psychosocial intervention to improve late life depression in socioeconomically deprived areas of Sao Paulo, Brazil (PROACTIVE): feasibility study of a psychosocial intervention for late life depression in Sao Paulo. BMC PUBLIC HEALTH, v. 19, n. 1, AUG 22 2019. (13/50953-4)

HENRIQUE, MAIARA GARCIA; DE PAULA COUTO, MARIA CLARA P.; ARAYA, RICARDO; MENDES, ANA VILELA; NAKAMURA, CARINA AKEMI; HOLLINGWORTH, WILLIAM; VAN DE VEN, PEPIJN; PETERS, TIM J.; SCAZUFCA, MARCIA. Acceptability and fidelity of a psychosocial intervention (PROACTIVE) for older adults with depression in a basic health unit in Sao Paulo, Brazil: a qualitative study. BMC PUBLIC HEALTH, v. 21, n. 1, DEC 14 2021. (13/50953-4)