The rising burden of non-communicable diseases (NCDs), including mental health disorders (MHDs) such as anxiety and depression, poses a significant public health challenge globally. Evidence suggests that both diabetes and hypertension, the two most prevalent NCDs, are linked to a higher prevalence of MHDs. However, there is a lack of evidence on prevalence of generalised anxiety disorder (GAD) and depression among adults living with both diabetes and hypertension in Bangladesh. We aimed to assess the prevalence of GAD and depression and explore the associated factors among adults living with diabetes and hypertension comorbidity in rural Bangladesh.

We implemented a cross-sectional study.

The study was conducted in Chirirbandar, a sub-district of Dinajpur, Bangladesh.

We interviewed a total of 387 adults living with diabetes and hypertension comorbidity.

We had two primary outcome measures: GAD and depression. Individuals scoring ≥10 on the General Anxiety Disorder-7 scale were considered as having GAD and individuals scoring ≥10 on the Patient Health Questionnaire-9 scale were considered as having depression. The outcome variables were dichotomised based on these scores.

The prevalence of GAD was 7.24% (95% CI 5.04 to 10.29). Education level (grades 5–9) (adjusted OR (AOR): 3.40, 95% CI 1.26 to 9.19) and household wealth status (highest wealth tertile) (AOR: 0.12, 95% CI 0.02 to 0.62) were associated with GAD. The prevalence of depression was 17.83% (95% CI 14.32 to 21.98). Socioeconomic factors associated with depression included unemployment (AOR: 3.26, 95% CI 1.05 to 10.10) and household wealth status (highest wealth tertile) (AOR: 0.45, 95% CI 0.21 to 0.98). Higher odds of depression were also observed among participants with controlled hypertension (AOR: 3.88, 95% CI 1.81 to 8.35). Other factors, such as tobacco use, dietary diversity and physical activity, were not associated with GAD or depression.

A high prevalence of GAD and depression was observed among adults living with diabetes and hypertension comorbidity. The findings from the study emphasise the need for integration of mental health services into the existing non-communicable disease care. The identified factors associated with GAD or depression should be considered to develop targeted interventions for people with hypertension and diabetes comorbidity in Bangladesh.

This study aimed to assess treatment outcome, medication adherence and predictors among epilepsy patients at three low-resource setting hospitals in Mekelle City, Northern Ethiopia.

A multicentre hospital-based observational cross-sectional study was conducted.

The study was conducted in three resource-limited tertiary care hospitals in Mekelle City, Northern Ethiopia: Ayder Comprehensive Specialized Hospital, Mekelle General Hospital and Quiha General Hospital.

A total of 351 patients with epilepsy receiving regular follow-up care at adult neurology outpatient clinics in three low-resource setting hospitals were included in the study.

The study assessed adherence to antiepileptic drugs (AEDs), treatment outcomes and identified independent predictors of these outcomes.

A total of 351 study participants were included in the final analysis, with a mean (±SD) age of 37.98±14.27 years. More than one-third (39%) had poorly controlled seizures. Living in urban areas (adjusted odds ratio (AOR)= 3.36, 95% CI 1.1 to 10.4, p=0.037), being government-employed (AOR = 4.0, 95% CI 1.1 to 14.5, p=0.035) and being a student (AOR = 4.0, 95% CI 1.1 to 14.5, p=0.035) were associated with good seizure control. Half of the participants (177, 50.6 %) were non-adherent to their medications. Being a farmer (AOR = 4.2, 95% CI 1.5 to 11.3, p=0.005), a housewife (AOR = 4.9, 95% CI 1.4 to 17.2, p=0.012), absence of seizure-triggering factors (AOR = 3.7, 95% CI 2.34 to 6.06, p

More than two-thirds of patients with epilepsy experienced poor seizure control. Place of residence, employment status and the number of seizure episodes prior to treatment initiation were identified as significant predictors of treatment outcomes. Approximately half of the study participants were adherent to their medications, with employment status, the presence of seizure-triggering factors, comorbidities and seizure control serving as predictors of medication adherence.

There is increasing awareness of the impact of living with multiple long-term conditions (referred to as multimorbidity) on patients and health systems. Managing multimorbidity remains a challenge for primary care providers; necessitating tailored interventions that are both clinically and cost effective. In the Irish health system, two pilot trials have demonstrated promising results for patients living with multimorbidity. The first, MultimorbiditY COllaborative Medication Review And DEcision making (MyComrade), involved pharmacists supporting the management of polypharmacy, and the second, Link MultiMorbidity (LinkMM), involved link workers delivering social prescribing. This definitive trial aims to evaluate the clinical and cost effectiveness of both these interventions, as well as conduct a process evaluation.

This is a pragmatic, multi-arm, definitive, cluster randomised controlled trial in Irish general practices. The trial will include three arms: (1) MyComrade; (2) LinkMM and (3) usual care, acting as an efficient shared control arm for both interventions. For this trial, 672 patients will be recruited from 48 general practices. The eligibility criteria for the patients will be: (1) over 18 years of age; (2) has two or more chronic conditions; (3) taking 10 or more regular medicines and (4) attending their general practice team for chronic disease management. Outcome data will be collected for all participants, across all trial arms at baseline and 6 months. Primary outcomes include the number of medicines (reflecting the MyComrade intervention) and patient capability (reflecting the LinkMM intervention). Secondary outcomes include proportions and types of potentially inappropriate medications, patient experience of care, patient activation, self-rated health, health-related quality of life, mortality and healthcare utilisation. Quantitative and qualitative data will be collected to inform the process evaluation. Additionally, an economic evaluation will be conducted to evaluate the cost-effectiveness of both interventions compared with the control arm.

The trial protocol was approved by the Irish College of General Practice (ICGP) Ethical Review Board (ref: ICGP_Rec_2023_016). A formal knowledge dissemination plan has been developed for the trial, which includes peer-reviewed publications, conference presentations and reports to healthcare professionals, commissioners and policymakers.

ISRCTN11585238.

Adolescence is a time of rapid physical, social and psychological development and many risk factors for mental disorders have their roots in this age period. Primary prevention through school platforms has been extensively used and evaluated, but many interventions have poor uptake, high dropout and limited long-term sustainability. Mental health is a complex phenomenon and may be best supported through multicomponent interventions that more holistically consider inner, social and environmental levels. Character education-focused interventions are effective for improving adolescent psychosocial functioning and mental well-being. Therefore, an intervention that focuses on developing these strengths and is delivered within a school environment, through an adolescent-informed approach using creativity-focused components, has the potential to improve adolescent mental health and well-being.

This protocol describes the YiPEE cluster-randomised controlled trial with concurrent mixed-methods process evaluation and economic evaluation, which aims to determine the impact of a multilevel multicomponent intervention in schools in Chennai, Tamil Nadu, India. Clusters—defined as schools which include Grades 6–8 (ages 11–16 years), will be randomised to intervention (n=15) or control (n=15). The intervention consists of: an 8-week classroom-based component, a 12-week teacher-focused component and a board comprising members from across the whole school. All children attending Grade 7 (aged 12–15) will be exposed to the classroom component, and teachers who actively teach Grade 7 will be invited to participate in the teacher component. Within schools, students for the individual-level evaluation will be included if they are: (1) aged 12–15 years; (2) currently attending Grade 7; (3) competent to give consent and (4) have a legal guardian competent of giving consent. We aim to sample a minimum of 100 students from each school (n=3000). All teachers of Grades 6–8 will be recruited for the evaluation. The primary outcome is symptoms of anxiety and depression measured using an abbreviated version of the UNICEF MMAPP tool. The primary analysis will be intention-to-treat, comparing the mean change in mental health score between baseline and endline, between intervention and control clusters. In addition, we will record school monitoring data (student attendance, student grades). Individual interviews with students and teachers, focus group discussions with school staff, and ethnographic observations will provide data for the process evaluation. For the economic evaluation, the combined direct and non-direct costs will be compared with changes in mental health in the intervention arm.

The trial is approved by the Ethics Council of the Schizophrenia Research Foundation, India, with approval number EC/NEW/INST/2023/TN/0329. We plan to publish the main impact, process and economic evaluation results as academic publications in international peer-reviewed journals in 2026.

Clinical Trials Registry—India (CTRI/2024/07/070949).

This study investigated the correlation between the type of health insurance membership as a proxy for the economic status of patients and the severity of their type two diabetes mellitus (T2DM) in Indonesia.

The study conducted a secondary analysis of National Health Insurance (Jaminan Kesehatan Nasional) claim data provided by the Indonesian Social Security Agency, Badan Penyelenggara Jaminan Sosial (BPJS). We used ordered logistic regression with four severity levels for T2DM (0=outpatient, I=mild, II=moderate, III=severe) as dependent variables. The main independent variables (insurance membership categories) included subsidised insurance members (PBI), a combination of formally employed and nonsalaried informal workers (PBPU & PPU) and nonworkers (BP).

Secondary healthcare facilities in Indonesia.

The dataset included 2 989 618 claims for hospital visits of people with T2DM from 2018 to 2022.

Severity level of T2DM patients.

A higher percentage of T2DM patients who visited healthcare facilities with subsidised insurance (PBI), which represents a low-income group, have severe disease (6.9%) than patients in the PBPU & PPU (4.9%) and BP categories (5.5%). Moreover, regression analysis revealed that having PBI membership status was associated with a greater OR of having severe T2DM than nonsubsidised members. Among T2DM patients in the nonsubsidised insurance category, workers (PBPU & PPU) had an OR of 0.74 (95% CI: 0.735 to 0.745; p

These findings illustrate the lack of optimal access to health services for diabetes patients in low-income insurance membership categories and the challenges of better treatment in health facilities for low-income patients.