Depression in Old Age
Conditions
Brief summary
The aim of this hybrid (Effectiveness-Implementation) cluster randomised controlled clinical trial is to test the feasibility of implementing an age-appropriate electronic version of the WHO Mental Health Gap Action Programme Intervention Guide (emhGAP-Age) in routine home-based care of older Nigerians with depression. The main questions it aims to answer are: 1. Whether the emhGAP-Age demonstrate sufficient signals of effectiveness in the identification and home management of late life depression to permit for further exploration in a fully powered clinical trial? 2. What are the logistical, programmatic, and operational requirements for a home-delivered emhGAP-Age in a sample of older people with depression in Nigeria? Consenting older participants with depression in the intervention arm will receive treatment based on emhGAP-Age which consists of; * Adapted electronic generic version of the WHO Mental Health Gap Action Programme Intervention Guide (emhGAP-IG) * Adapted Problem-Solving Therapy (PST-PC) * Support/supervision of providers * Links to social support resources. Researchers will compare with treatment based on the basic specification in the generic emhGAP-IG (consisting of basic psychoeducation and stress reduction) for effects on depression remission.
Interventions
BEHAVIORALemhGAP-Age
* Adapted emhGAP-IG; * Adapted Problem-Solving Therapy (PST-PC) * Support/supervision of lay providers * Links to social support resources.
Sponsors
University of Ibadan
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
HEALTH_SERVICES_RESEARCH
Masking
SINGLE (Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
60 Years to No maximum
Healthy volunteers
No
Inclusion criteria
1. Age ≥ 60 years, 2. PHQ-9 score of ≥11 during routine consultation
Exclusion criteria
1. Severe co-morbidity requiring urgent attention. 2. Severe cognitive impairment/dementia (Community Screening Instruments for Dementia score≤ 20) . 3. Active suicidal intention. 4. Evidence of bipolar/psychosis/severe substance use disorders. 5. Planning to move out of the study catchment area within 6 months. 6. Refusing/lacking capacity to consent/accent
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Depression remission | At six months post trial entry | Patient Health Questionnaire (PHQ-9) score \< 6 |
Outcome results
None listed