Lay health supporters aided by a mobile phone messaging system to improve care of villagers with schizophrenia in Liuyang, China: protocol for a randomised control trial
Open accessAbstract
Introduction: Schizophrenia is a severe, chronic and disabling mental illness. Non-adherence to medication and relapse may lead to poorer patient function. This randomised controlled study, under the acronym LEAN (Lay health supporter, e-platform, award, and iNtegration), is designed to improve medication adherence and high relapse among people with schizophrenia in resource poor settings. Methods/analysis: The community-based LEAN has four parts: (1) L ay health supporters (LHSs), mostly family members who will help supervise patient medication, monitor relapse and side effects, and facilitate access to care, (2) an E -platform to support two-way mobile text and voice messaging to remind patients to take medication; and alert LHSs when patients are non-adherent, (3) an A ward system to motivate patients and strengthen LHS support, and (4) iNtegration of the efforts of patients and LHSs with those of village doctors, township mental health administrators and psychiatrists via the e-platform. A random sample of 258 villagers with schizophrenia will be drawn from the schizophrenic ‘686’ Program registry for the 9 Xiang dialect towns of the Liuyang municipality in China. The sample will be further randomised into a control group and a treatment group of equal sizes, and each group will be followed for 6 months after launch of the intervention. The primary outcome will be medication adherence as measured by pill counts and supplemented by pharmacy records. Other outcomes include symptoms and level of function. Outcomes will be assessed primarily when patients present for medication refill visits scheduled every 2 months over the 6-month follow-up period. Data from the study will be analysed using analysis of covariance for the programme effect and an intent-to-treat approach. Ethics and dissemination: University of Washington: 49464 G; Central South University: CTXY-150002-6. Results will be published in peer-reviewed journals with deidentified data made available on FigShare. Trial registration number: ChiCTR-ICR-15006053; Pre-results.
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For three of the interventions summarized, large-scale evaluations of effectiveness are currently ongoing.
“Importantly, for three of the interventions using digital technology that we summarized here, large-scale evaluations of effectiveness are currently ongoing (published protocols for these studies were included).25,34,37”
From Digital Technology for Building Capacity of Nonspecialist Health Workers for Task Sharing and Scaling Up Mental Health Care Globally (2019) · cites this paper as [34]
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- [9]Dongming S, Jiyue H, Wenjun Z The development of community based mental health services in Liuyang. Chinese Mental Health J 2011; 25: 517– 20.
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- Authors
- Xu, D. (., Gong, W., Caine, E. D., Xiao, S., Hughes, J. P., Ng, M., Simoni, J., He, H., Smith, K. L., Brown, H. S., & Gloyd, S.
- Affiliations
- Sun Yat-sen University (CN)
- Central South University (CN)
- University of Rochester Medicine (US)
- University of Washington (US)
- Tulane University (US)
- The University of Texas Health Science Center at Houston (US)
- Michael & Susan Dell Center for Healthy Living (US)
- Corresponding author
- Gong, Wenjie
- ORCID
- Venue
- BMJ Open
- Publisher
- BMJ
- Published
- 2016-01
- Volume
- 6
- Issue
- 1
- Pages
- e010120
- ISSN
- 2044-6055 (ISSN-L)
- PMC
- PMC4735204
- OpenAlex
- W2287633326
- Cited by
- 21
- References
- 35
- Citations by year
- 2024: 1 · 2022: 2 · 2021: 2 · 2020: 4 · 2019: 4 · 2018: 7 · 2017: 1
- FWCI
- 5.35
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- cc-by-nc
- Locations
- BMJ Open (publishedVersion, cc-by-nc)
- PubMed Central (publishedVersion, cc-by-nc)
- PubMed (publishedVersion)
- HighWire Press Open Archive (acceptedVersion)
- Funders
- Sun Yat-sen University
- Fogarty International Center (R25TW009345, D43TW009101)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Family Caregiving in Mental Illness
- Health Sciences › Medicine › Family Practice › Medication Adherence and Compliance
- Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
- Keywords
- schizophrenia, family caregivers, text messaging, medication adherence, relapse prevention, community mental health services, resource-limited settings, village doctors, award system, pill count, Xiang dialect, Liuyang
- MeSH terms
- China, Clinical Protocols, Humans, Medically Underserved Area, Schizophrenia, Antipsychotic Agents, Caregivers, Telemedicine, Rural Health Services, Cell Phone, Medication Adherence, Quality Improvement, Text Messaging
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