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Evidence-based guideline implementation in low and middle income countries: lessons for mental health care

Overview of attention for article published in International Journal of Mental Health Systems, January 2017
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  • Good Attention Score compared to outputs of the same age (66th percentile)
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4 tweeters

Citations

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19 Dimensions

Readers on

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123 Mendeley
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Title
Evidence-based guideline implementation in low and middle income countries: lessons for mental health care
Published in
International Journal of Mental Health Systems, January 2017
DOI 10.1186/s13033-016-0115-1
Pubmed ID
Authors

Mary Docherty, Kate Shaw, Lucy Goulding, Hannah Parke, Erica Eassom, Farnoosh Ali, Graham Thornicroft

Abstract

There is a significant treatment gap in provision of effective treatment for people with mental disorders globally. In some Low and Middle Income Countries (LMICs) this gap is 90% or more in terms of untreated cases. Clinical practice guidelines (CPGs) are one tool to improve health care provision. The aim of this review is to examine studies of the effectiveness of evidence-based CPG implementation across physical and mental health care, to inform mental healthcare provision in low and middle income countries (LMICs), and to identify transferable lessons from other non-communicable diseases to mental health. A systematic literature review employing narrative synthesis and utilising the tools developed by the Cochrane Effective Practice and Organisation of Care (EPOC) group was conducted. Experimental studies of CPG implementation relating to non-communicable diseases, including mental disorders, in LMICs were retrieved and synthesised. Few (six) studies were identified. Four cluster randomised controlled trials (RCTs) related to the introduction of CPGs for non-communicable diseases in physical health; one cluster-RCT included CPGs for both a non-communicable disease in physical health and mental health, and one uncontrolled before and after study described the introduction of a CPG for mental health. All of the included studies adopted multi-faceted CPG implementation strategies and used education as part of this strategy. Components of the multi-faceted strategies were sometimes poorly described. Results of the studies included generally show statistically significant improvement on some, but not all, outcomes. Evidence for the effectiveness of interventions to improve uptake of, and compliance with, evidence-based CPGs in LMICs for mental disorders and for other non-communicable diseases is at present limited. The sparse literature does, however, suggest that multifaceted CPG implementation strategies that involve an educational component may be an effective way of improving guideline adherence and therefore of improving clinical outcomes. Further work is needed to examine cost-effectiveness of CPG implementation strategies in LMICs and to draw conclusions on the transferability of implementation experience in physical health care to mental health practice settings. Strategies to ensure that CPGs are developed with clear guidance for implementation, and with explicit, methods to evaluate them should be a priority for mental health researchers and for international agencies.

Twitter Demographics

The data shown below were collected from the profiles of 4 tweeters who shared this research output. Click here to find out more about how the information was compiled.

Mendeley readers

The data shown below were compiled from readership statistics for 123 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
India 1 <1%
Unknown 122 99%

Demographic breakdown

Readers by professional status Count As %
Student > Master 22 18%
Researcher 17 14%
Student > Bachelor 12 10%
Student > Postgraduate 10 8%
Student > Ph. D. Student 10 8%
Other 31 25%
Unknown 21 17%
Readers by discipline Count As %
Medicine and Dentistry 27 22%
Psychology 19 15%
Nursing and Health Professions 18 15%
Social Sciences 8 7%
Engineering 4 3%
Other 21 17%
Unknown 26 21%

Attention Score in Context

This research output has an Altmetric Attention Score of 4. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 06 March 2017.
All research outputs
#5,832,523
of 18,777,296 outputs
Outputs from International Journal of Mental Health Systems
#356
of 656 outputs
Outputs of similar age
#135,072
of 402,556 outputs
Outputs of similar age from International Journal of Mental Health Systems
#29
of 46 outputs
Altmetric has tracked 18,777,296 research outputs across all sources so far. This one has received more attention than most of these and is in the 68th percentile.
So far Altmetric has tracked 656 research outputs from this source. They typically receive a little more attention than average, with a mean Attention Score of 7.4. This one is in the 45th percentile – i.e., 45% of its peers scored the same or lower than it.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 402,556 tracked outputs that were published within six weeks on either side of this one in any source. This one has gotten more attention than average, scoring higher than 66% of its contemporaries.
We're also able to compare this research output to 46 others from the same source and published within six weeks on either side of this one. This one is in the 36th percentile – i.e., 36% of its contemporaries scored the same or lower than it.