Published online by Cambridge University Press: 02 January 2018
We open with some major and significant randomised controlled trials exploring interventions in resource-poor societies. Two papers bythe same team writing in the Lancet explore the use ofnon-specialist ‘lay counsellor’ health workers to deliver briefpsychological interventions for excessive alcohol consumption and depressionin India. Male harmful drinkers in ten primary health centres wererandomised to receive either enhanced usual care (EUC), or EUC andCounselling for Alcohol Problems (CAP). The active intervention producedsignificantly greater remission and abstinence rates, with an incrementalcost per additional remission of $217. A Healthy Activity Program (HAP) formoderately to severely depressed men and women was evaluated in a differentcohort, with a parallel design of EUC compared with EUC plus therapy. Onceagain, the active intervention produced significant improvements, withreductions in depression symptomatology and remission, as well as decreasedillness consequences such as days out of work and intimate partner violence.Both interventions were reported to be acceptable to patients and practicalfor delivery in primary care settings.
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