Chronic diseases – namely hypertension, depression and diabetes – are the leading burden of diseases in most Latin American countries. This is likely to get worse as life expectancy increases and the proportion of elderly people increases. These three chronic diseases are highly co-morbid. Behavioural approaches are crucial in the management of this comorbidity. Working with key stakeholders, this study in Peru and Argentina aims to co-design an integrated management programme with the support of technology and active community involvement. This would be the first of such integrated programmes in the region, and hopefully can be easily transferred to other similar countries.
Professor Ricardo Araya, Professor of Global Mental Health at King’s IoPPN
21 November 2024
King's receives £4.6 million NIHR funding to improve healthcare for chronic conditions in Latin America
King’s researchers have been awarded £4.6 million from the National Institute for Health and Care Research (NIHR) to co-develop an intervention for people with depression, hypertension and/or diabetes among vulnerable populations in Peru and Argentina.
Depression, hypertension and diabetes are the three biggest health problems in Peru, Argentina and across most Latin American countries. These conditions often present together (co-morbid), which makes it challenging to treat them effectively. Healthcare for people with these chronic health problems in Latin American countries is often limited and of low quality, with a shortage of medical doctors.
Led by Professor Ricardo Araya at the Institute of Psychiatry, Psychology & Neuroscience (IoPPN) at King’s College London, researchers will collaborate with local communities to understand the context, barriers and enablers to healthcare for chronic conditions in Peru and Argentina.
The team will work to co-adapt existing treatments and, where needed, co-develop new treatments to create an intervention designed to support people with depression, hypertension and/or diabetes. The intervention will utilise a digital platform to support the treatment of patients and to better connect primary care (for example, clinics and hospitals) with broader community support.
They will evaluate the effectiveness of this intervention by a cluster randomised controlled trial in primary care clinics in Peru and Argentina over a period of one year.
The research programme, titled “CO-morbid Long-term disease Management in the Americas: blended intervention (COLMA)” is a collaboration between King's, the Institute for Clinical Effectiveness and Health Policy at University of Buenos Aires (Argentina), Universidad Científica del Sur (Peru), University of Limerick (Ireland), University of Edinburgh, and a community organisation based in Lima, Peru.
The new funding will allow the team to build on their previous work. They have already developed effective treatments for chronic physical and mental conditions in Brazil, Colombia and Chile, and conducted several studies using technology to support the treatment of depression, hypertension and diabetes in Latin American countries.
They also pioneered a ‘task-shifting’ approach to mental healthcare, meaning that responsibilities are redistributed to non-specialist workers. Instead of relying on mental health professionals like psychiatrists or psychologists – who are in short supply across Latin American countries, especially in underserved areas – certain mental health tasks are assigned to community members, for example through community support groups.
The team will build on this to develop and test a new intervention, adapted for use among vulnerable populations in Peru and Argentina that can easily be transferred to other neighbouring countries in the region.
The research is funded under the NIHR Research and Innovation for Global Health Transformation (RIGHT) Programme.
For more information, please contact Milly Remmington (School of Mental Health & Psychological Sciences Communications Manager).
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Professor of Global Mental Health