Schizoaffective Disorder, Schizophrenia
Conditions
Keywords
Relapse Prevention, People with Schizophrenia, Text-Messaging, Assertive Community Treatment (ACT)
Brief summary
The purpose of this study is to examine whether Texting for Relapse Prevention (T4RP), a text messaging-based early warming for relapse prevention in people who have schizophrenia/SAD, is associated with fewer relapse symptoms compared to a treatment-as-usual control group.
Detailed description
Schizophrenia is among the 20 most debilitating illnesses worldwide, responsible for 1% of the global burden of disease. Schizoaffective disorder (SAD) affects an additional 0.2% to 1.1% of adults. As many as four out of five people who have schizophrenia or SAD relapse within 5 years of recovery from their initial episode. Interventions aimed at early intervention to prevent relapse would impact public health. The Texting for Relapse Prevention (T4RP) is an innovative service delivery program delivered via text messaging designed for people who have schizophrenia/SAD. The intervention will be tested in a randomized controlled trial against a treatment-as-usual control group which, for most, involved meeting with their therapist every 2 to 4 weeks and meeting with their psychiatrist at least once every 90 days or more frequently as clinically indicated. A total of 40 people with schizophrenia and 5-15 provider participants (depending on the patient distribution across the providers) in the pilot RTC. The study is being conducted by researchers at the Center for Innovative Public Health Research and Johns Hopkins Community Psychiatry Program (JHCPP). The investigators posit that T4RP will reduce psychiatric morbidity and institutionalization rates and promote recovery by facilitating improved patient-provider communication, promoting medication adherence, helping people self-monitor their early warning signs, and promoting self-management of symptoms. If T4RP is effective, this cost-effective and easily scalable intervention will make a significant public health impact and reduction in relapse-related costs for people with schizophrenia/SAD.
Interventions
BEHAVIORALTexting for Relapse Prevention (T4RP)
T4RP is a relapse prevention mHealth program text messaging to people who have schizophrenia/SAD. Content is guided by components of the Assertive Community Treatment (ACT) and focuses on facilitating improved patient-provider communication, promoting medication adherence, helping people self-monitor their early warning signs, and promoting self-management of symptoms.
Sponsors
Johns Hopkins University
National Institute of Mental Health (NIMH)
Center for Innovative Public Health Research
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
PREVENTION
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
Yes
Inclusion criteria
* be English-speaking; * have a chart diagnosis of schizophrenia or SAD * be able to provide consent (i.e., pass the Capacity to Consent screen) * own a cell phone and report using the text messaging function * be currently at their personal baseline with regard to symptoms and functioning as assessed by their provider (i.e., not in relapse and compliant with treatment) * be actively under the care of a mental health provider enrolled in the program * agree to continue attending the clinic for the duration of the study * plan to keep the same cell phone number for the duration of the study * have at least one of their providers consent to take part in the study
Exclusion criteria
* have at least one of their providers consent to take part in the study
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Recovery Assessment Scale | 6-months post-study enrollment | It is a 41-item self-report scale with 5 subscales that measure an individual's experience of recovery |
| Montgomery-Asberg Depression Scale (MADRS) | 6-months post-study enrollment | It is a clinician-administered 10-item scale developed to measure changes in depressive symptom during treatment. |
| Young Mania Rating Scale (YMRS) | 6-months post-study enrollment | It is is an 11-item clinician administered scale that assesses the presence and severity of manic symptoms. |
| Institutionalization | 6-months post-study enrollment | The number of hospitalizations or ER crisis visits during the study period |
| The Positive and Negative Syndrome Scale (PANSS) | 6-months post-study enrollment | It has three subscales that measure: positive symptoms of schizophrenia, negative symptoms of schizophrenia, and general psychopathology. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Boston University Empowerment Scale | 6-months post-intervention | It is a 28-item self-report scale that measures empowerment among those using mental health services. |
| Brief Cognitive Assessment | 6-months post-intervention | It is a clinician administered test that consists of 3 standard tests: Verbal Fluency, Hopkins Verbal Learning Test and Trails A and B and has been shown to be related to measures of functional outcome in patients with schizophrenia. |
| Brief Adherence Rating Scale | 6-months post-intervention | It is a clinician-administered, 4-item scale that has three questions and an overall visual analog scale. It was designed for use in community settings with individuals who have schizophrenia or schizoaffective disorder and has been validated against electronically-monitored adherence. |
Countries
United States
Outcome results
None listed