CAE for Poorly Adherent Individuals With Schizophrenia

N/ACompletedNCT06061952

University Hospitals Cleveland Medical Center36 enrolled

Overview

This project aims to evaluate the feasibility, acceptability and preliminary efficacy of remotely delivered CAE among patients with schizophrenia (CAE-S).

Patients with schizophrenia will be randomly assigned to receive either CAE-S or eTAU following the baseline assessment. The primary feasibility outcomes will be attendance and patient satisfaction (Aim 1) and change from baseline to 12 weeks in schizophrenia symptoms as measured by the Positive and Negative Symptom Scale (PANSS) (Aim 2). An exploratory evaluation (Aim 3) will examine the posited mechanistic underpinnings of the CAE-S intervention by assessing change from screening to 12 weeks in psychotropic medication adherence as measured by the Tablets Routine Questionnaire (TRQ) and validated by eCAP (objective bottle openings). Secondary measures will include the Clinical Global Impression (CGI), functional status, quality of life and attitudes towards medication.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

OTHER

Masking

NONE

Enrollment

Conditions

Schizophrenia

Interventions

Customized Adherence Enhancement for Schizophrenia (CAE-S)BEHAVIORAL

6-session series spaced out over approximately 6-10 weeks

Enhanced Treatment as Usual (eTAU)OTHER

eTAU participants will view a pre-taped series of 6 videos

Eligibility

Sex: ALLMin age: 18 Years

Medical Language ↔ Plain English

Inclusion Criteria: * Individuals age 18 and older with schizophrenia as confirmed by the Mini International Psychiatric Inventory (MINI) * Prescribed an antipsychotic medication for treatment of schizophrenia * Known to have medication treatment adherence problems as identified by the Tablets Routine Questionnaire (TRQ, 20% or more missed medications in past week or past month) * Ability to be rated on psychiatric rating scales * Currently in treatment or scheduled to receive treatment at a Community Mental Health Clinic (CMHC) or other clinical setting able to provide mental health care during and after study participation * Able to provide written, informed consent to study participation * Has access to electronic device and internet to complete sessions conducted on videoconferencing platform Exclusion Criteria: * Prior or current treatment with clozapine (clozapine therapy includes additional medication-related monitoring and clinical visits that may impact medication adherence) * Medical condition or illness, which in the opinion of the research psychiatrist, would interfere with the patient's ability to participate in the trial * Physical dependence on substances (alcohol or illicit drugs) likely to lead to withdrawal reaction during the course of the study in the clinical opinion of the treated research psychiatrist * Immediate risk of harm to self or others * Female who is currently pregnant or breastfeeding

Locations (1)

University Hospitals Cleveland Medical Center

Cleveland, Ohio, United States

Outcomes

Primary Outcomes

Average Number of CAE-S Sessions Attended by Those in the CAE-S Group After 12 Weeks

Time frame: 12 weeks

Percentage of Subjects in the CAE-S Group That Agree or Strongly Agree That the Intervention Was Useful at 12 Weeks

Time frame: 12 weeks

Secondary Outcomes

Change in Positive and Negative Syndrome Scale (PANSS) Total Score Between CAE-S and eTAU Groups at 12 Weeks

The PANSS is a clinician rated scale used for measuring symptom severity of patients with schizophrenia. Total scores range from 30 to 210, with higher scores indicating more severe schizophrenia

Time frame: 12 weeks

Change in Tablets Routine Questionnaire in the Past 7 Days (TRQ) at 12 Weeks

The TRQ is a validated self-report measure that identifies proportion of days with missed doses in the past 7 days (past-week) and in the past 30 days (past-month). Lower scores (a smaller proportion/percentage n of missed medication) represent better adherence, while higher scores (a larger proportion/percentage of missed medication) represent worse adherence.

Time frame: 12 weeks

Change in Tablets Routine Questionnaire in the Past 30 Days (TRQ) at 12 Weeks

Time frame: 12 weeks

Change in eCAP Use in the Past Week at 12 Weeks

Study participants will be given an eCAP device for one of their pill bottles, which will record time/date of bottle opening. eCAP will be used to monitor the antipsychotic dosed most often (index drug). If more than one drug is dosed at the same frequency, the antipsychotic most recently added to the regimen will be the index drug.. Investigators will calculate a percent of doses taken by dividing the number of times the bottle is opened by the number of times it should have been opened as per the prescription.

Data from ClinicalTrials.gov

This platform is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional.