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.
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.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
PREVENTION
Masking
NONE
Enrollment
40
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.
Johns Hopkins Community Psychiatry Program (JHCPP)
Baltimore, Maryland, United States
The Positive and Negative Syndrome Scale (PANSS)
It has three subscales that measure: positive symptoms of schizophrenia, negative symptoms of schizophrenia, and general psychopathology.
Time frame: 6-months post-study enrollment
Montgomery-Asberg Depression Scale (MADRS)
It is a clinician-administered 10-item scale developed to measure changes in depressive symptom during treatment.
Time frame: 6-months post-study enrollment
Young Mania Rating Scale (YMRS)
It is is an 11-item clinician administered scale that assesses the presence and severity of manic symptoms.
Time frame: 6-months post-study enrollment
Institutionalization
The number of hospitalizations or ER crisis visits during the study period
Time frame: 6-months post-study enrollment
Recovery Assessment Scale
It is a 41-item self-report scale with 5 subscales that measure an individual's experience of recovery
Time frame: 6-months post-study enrollment
Brief Adherence Rating Scale
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.
Time frame: 6-months post-intervention
Boston University Empowerment Scale
It is a 28-item self-report scale that measures empowerment among those using mental health services.
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Time frame: 6-months post-intervention
Brief Cognitive Assessment
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.
Time frame: 6-months post-intervention