Customising informed consent procedures for people with schizophrenia in India

Sudipto Chatterjee, Berit Kieselbach, Smita Naik, Shuba Kumar, Sujit John*, Madhumitha Balaji, Mirja Koschorke, Hamid Dabholkar, Mathew Varghese, Vikram Patel, Graham Thornicroft, Rangaswamy Thara

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

8 Citations (Scopus)

Abstract

Background: There is little information on how the ethical and procedural challenges involved in the informed participation of people with schizophrenia in clinical trials are addressed in low- and middle-income countries (LMICs). The informed consent procedure used in the collaborative community care for people with schizophrenia in India (COPSI) RCT was developed keeping these challenges in mind. We describe the feasibility of conducting the procedure from the trial, researcher and participants perspectives and describe the reasons for people consenting to participate in the trial or refusing to do so. Methods: Three sources of information were used to describe the feasibility of the COPSI consent procedure: key process indicators for the trial perspective, data from a specially designed post-interview form for participant’s observations and focus group discussion (FGD) with the research interviewers. Categorical data were analysed by calculating frequencies and proportions, while the qualitative data from the FGD, and the reasons for participation or refusal were analysed using a thematic content analysis approach. Findings: 434 people with schizophrenia and their primary caregiver(s) were approached for participation in the trial. Consent interviews were conducted with 332, of whom 303 (91 %) agreed to participate in the trial. Expectation of improvement was the most common reason for agreeing to participate in the trial, while concerns related to the potential disclosure of the illness, especially for women, were an important reason for refusing consent. Conclusions: The COPSI consent procedure demonstrates preliminary, observational information about the feasibility of customising informed consent procedures for people with schizophrenia LMIC contexts. This and other similar innovations need to be refined and rigorously tested to develop evidence-based guidelines for informed consent procedures in such settings.

Original languageEnglish
Pages (from-to)1527-1536
Number of pages10
JournalSocial Psychiatry and Psychiatric Epidemiology
Volume50
Issue number10
DOIs
Publication statusPublished - 3 Oct 2015

Keywords

  • Capacity for consent
  • COPSI trial
  • India
  • Informed consent procedure
  • Schizophrenia

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