The effectiveness of a solution-focused approach (DIALOG+) for patients with severe mental illness and epilepsy in Uganda: A randomised controlled trial

Birabwa-Oketcho, Harriet; Nakasujja, Noeline; Alinaitwe, Racheal; Bird, Victoria; Priebe, Stefan; Sewankambo, Nelson

doi:10.1016/j.psycom.2022.100097

Cited by 2 publications

(3 citation statements)

References 19 publications

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“…The objective social situation of patients was assessed using the Objective Social Outcomes Index (SIX) [34]. These measures were selected to be consistent with the other studies being conducted in the NIHR Group [26,35,36], because they have been used in other studies in the settings or local language versions have been validated for use [37][38][39][40][41][42][43][44][45].…”

Section: Methodsmentioning

confidence: 99%

Feasibility and outcomes of using DIALOG+ in primary care to improve quality of life and mental distress of patients with long-term physical conditions: an exploratory non-controlled study in Bosnia and Herzegovina, Colombia and Uganda

van Loggerenberg,

Akena,

Alinaitwe

et al. 2023

BMC Prim. Care

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Introduction The management of long-term physical conditions is a challenge worldwide, absorbing a majority resources despite the importance of acute care. The management of these conditions is done largely in primary care and so interventions to improve primary care could have an enormous impact. However, very little data exist on how to do this. Mental distress is frequently comorbid with long term physical conditions, and can impact on health behaviour and adherence, leading to poorer outcomes. DIALOG+ is a low-cost, patient-centred and solution-focused intervention, which is used in routine patient-clinician meetings and has been shown to improve outcomes in mental health care. The question arises as to whether it could also be used in primary care to improve the quality of life and mental health of patients with long-term physical conditions. This is particularly important for low- and middle-income countries with limited health care resources. Methods An exploratory non-controlled multi-site trial was conducted in Bosnia and Herzegovina, Colombia, and Uganda. Feasibility was determined by recruitment, retention, and session completion. Patient outcomes (quality of life, anxiety and depression symptoms, objective social situation) were assessed at baseline and after three approximately monthly DIALOG+ sessions. Results A total of 117 patients were enrolled in the study, 25 in Bosnia and Herzegovina, 32 in Colombia, and 60 in Uganda. In each country, more than 75% of anticipated participants were recruited, with retention rates over 90% and completion of the intervention exceeding 92%. Patients had significantly higher quality of life and fewer anxiety and depression symptoms at post-intervention follow-up, with moderate to large effect sizes. There were no significant improvements in objective social situation. Conclusion The findings from this exploratory trial suggest that DIALOG+ is feasible in primary care settings for patients with long-term physical conditions and may substantially improve patient outcomes. Future research may test implementation and effectiveness of DIALOG+ in randomized controlled trials in wider primary care settings in low- and middle-income countries. Trial registration All studies were registered prospectively within the ISRCTN Registry. ISRCTN17003451, 02/12/2020 (Bosnia and Herzegovina), ISRCTN14018729, 01/12/2020 (Colombia) and ISRCTN50335796, 02/12/2020 (Uganda).

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Section: Methodsmentioning

confidence: 99%

Feasibility and outcomes of using DIALOG+ in primary care to improve quality of life and mental distress of patients with long-term physical conditions: an exploratory non-controlled study in Bosnia and Herzegovina, Colombia and Uganda

van Loggerenberg,

Akena,

Alinaitwe

et al. 2023

BMC Prim. Care

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“…As a result, there have been calls to implement low-cost resource-oriented interventions in low-income countries to address the mental health treatment gap. 8 , 9 There is evidence that resource-oriented approaches like enlisting the support of family members and friends of patients improve the management of SMI and empower individuals. 10 Models for involving families in the care of patients with SMI, often focusing on psycho-education and family therapy.…”

Section: Introductionmentioning

confidence: 99%

“…1,6 As a result, there have been calls to implement low-cost resource-oriented interventions in low-income countries to address the mental health treatment gap. 8,9 There is evidence that resource-oriented approaches like enlisting the support of family members and friends of patients Background: Treatment rates for severe mental illness (SMI) are low in low-and middleincome countries because of limited resources. Enlisting family support could be effective and low cost in improving patient outcomes.…”

Section: Introductionmentioning

confidence: 99%

Family Psycho-Social Involvement Intervention for severe mental illness in Uganda

Alinaitwe,

Seggane,

Turiho

et al. 2024

South African Journal of Psychiatry

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Background: Treatment rates for severe mental illness (SMI) are low in low- and middle-income countries because of limited resources. Enlisting family support could be effective and low cost in improving patient outcomes.Aim: The article assess the feasibility, acceptability and estimates of efficacy of Family Psychosocial Involvement Intervention (FAPII) for patients with SMI.Setting: Masaka Regional Referral Hospital and Mityana District Hospital in Uganda.Methods: This was a controlled pilot study with two sites randomly assigned as intervention and control. Thirty patients each with one or two family members and six mental health professionals were recruited at the intervention site. Five patients, their family members and two mental health professionals met monthly for 6 months to discuss pre-agreed mental health topics. Patient outcomes were assessed at baseline, 6- and 12-months and analysed using paired t-tests. The trial was prospectively registered (ISRCTN25146122).Results: At 6 and 12 months, there was significant improvement in the QoL in the intervention group compared to the control (p = 0.001). There was significant symptom reduction in the intervention group at 6 and 12 months (p 0.001). Family Psychosocial Involvement Intervention affected better treatment adherence at 6 and 12 months (p = 0.035 and p 0.001, respectively) compared to the control arm.Conclusion: Family Psychosocial Involvement Intervention improved QoL, medication adherence, reduced stigma and symptoms among patients with SMI. The authors recommend involving families in the care of patients with SMI in Uganda, with FAPII employing culturally sensitive psychotherapy.Contribution: The results support involvement of family in the care of patients with SMI.

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The effectiveness of a solution-focused approach (DIALOG+) for patients with severe mental illness and epilepsy in Uganda: A randomised controlled trial

Cited by 2 publications

References 19 publications

Feasibility and outcomes of using DIALOG+ in primary care to improve quality of life and mental distress of patients with long-term physical conditions: an exploratory non-controlled study in Bosnia and Herzegovina, Colombia and Uganda

Feasibility and outcomes of using DIALOG+ in primary care to improve quality of life and mental distress of patients with long-term physical conditions: an exploratory non-controlled study in Bosnia and Herzegovina, Colombia and Uganda

Family Psycho-Social Involvement Intervention for severe mental illness in Uganda

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