Schizoaffective Disorder, Schizophrenia, Schizophreniform Disorder
Conditions
Keywords
schizophrenia, adherence therapy, medication, randomized controlled trial, cost-effectiveness
Brief summary
When compared with those in the control (usual care) group, participants in the AT group are expected to demonstrate significant improvements immediately and at three, six and 12 months after completion of the intervention in: level of medication adherence, readmission rate, mental status, insight into treatment, and level of functioning.
Detailed description
When compared with those in the control (usual care) group, participants in the AT group are expected to demonstrate significant improvements immediately and at three, six and 12 months after completion of the intervention in the following aspects: 1. level of adherence to antipsychotic medication, 2. rate and length of psychiatric hospital readmission, 3. mental status, 4. insight and attitude into illness and treatment, and 5. level of functioning. The primary outcomes are level of antipsychotic medication adherence, re-hospitalization rates and mental status; and the patients' drug attitude will be the mediating factor of the AT.
Interventions
BEHAVIORALAdherence therapy
Systematic and highly structured medication adherence program using the motivational interviewing (MI) technique that focuses on six principles: expressing empathy, developing discrepancy between client's beliefs and evidence, supporting self-efficacy, avoiding argumentation, and rolling with resistance to behavioral change. MI is often able (with in-depth behavioral analysis) to focus on particular consequences of problem behavior, such as medication non-adherence, that have an obvious impact on patients.
Sponsors
Castle Peak Hospital
Kwai Chung Hospital
The Hong Kong Polytechnic University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
HEALTH_SERVICES_RESEARCH
Masking
SINGLE (Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
18 Years to 65 Years
Healthy volunteers
No
Inclusion criteria
of the patients include those who: * are Hong Kong Chinese residents; * have a primary diagnosis of schizophrenia or its subtypes such as schizophreniform and schizoaffective disorders not more than 3 years; * have been prescribed oral antipsychotics for at least 1 month; * are aged 18-65 years; * have Positive and Negative Syndrome Scale (PANSS) score \>60 and are judged by the case Community Psychiatric Nurse/psychiatrist as non-adherents; and * are able to understand Cantonese/Mandarin. Patients will be excluded if they have: * only depot/intramuscular injections as regular psychiatric medication; * co-morbidity of learning disability and organic brain disease, or clinically significant medical diseases; * participated in adherence therapy; and/or * visual, language or communication difficulty.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| re-hospitalization rate | 12 months after completion of intervention | rate and length of psychiatric hospital readmission immediately, 6 months and 12 months after the completion of the intervention undertaken |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| level of medication adherence | 12 months follow-up | level of adherence to antipsychotic medication measured at recruitment and at immediately, 6 months and 12 months after completion fo the intervention |
| mental status | 12 months follow-up | symptom severity measured at recruitment and at immediately, 6 months and 12 months after completion fo the intervention |
| insight into treatment | 12 months follow-up | insights into illness and treatment measured at recruitment and at immediately, 6 months and 12 months after completion fo the intervention |
| functioning | 12 months follow-up | level of functioning measured at recruitment and at immediately, 6 months and 12 months after completion fo the intervention |
Other
| Measure | Time frame | Description |
|---|---|---|
| program attendance and attrition | 12 months follow-up | attendance and attrition rate |
Countries
Hong Kong
Outcome results
None listed