TY - JOUR
T1 - Randomised control trial of the effectiveness of an integrated psychosocial health promotion intervention aimed at improving health and reducing substance use in established psychosis (IMPaCT)
AU - Gaughran, Fiona
AU - Stahl, Daniel
AU - Ismail, Khalida
AU - Greenwood, Kathryn
AU - Atakan, Zerrin
AU - Gardner-Sood, Poonam
AU - Stubbs, Brendon
AU - Hopkins, David
AU - Patel, Anita
AU - Lally, John
AU - Lowe, Philippa
AU - Arbuthnot, Maurice
AU - Orr, Diana
AU - Corlett, Sarah
AU - Eberhard, Jonas
AU - David, Anthony S.
AU - Murray, Robin
AU - Smith, Shubulade
AU - on behalf of the IMPaCT Team
AU - Harries, Bee
AU - Moore, Susan
AU - Bonaccorso, Stefania
AU - Kolliakou, Anna
AU - O'Brien, Conan
AU - Featherman, Ali
AU - Fung, Catherine
AU - Heslin, Margaret
AU - Dalemo, Keji
AU - Anakwe-Umeh, Stella
AU - Todd, Gill
AU - Mushore, Manyara
AU - Mutsatsa, Stanley
AU - Ohlsen, Ruth
AU - Howes, Oliver
AU - Papanastasiou, Evangelos
AU - Firdosi, Mohammad
AU - Sallis, Hannah
AU - Sambath, Irene
AU - Di Clemente, Guilia
AU - Breedvelt, Josefine
AU - Joseph, Candice
AU - Di Forti, Marta
AU - Odesanya, Adewale
AU - Onagbesan, Dami
AU - Case, Philippa
AU - Musa, Augustine
AU - Dalton, Christine
AU - Rudhra, Keerthana
AU - Treasure, Janet
AU - Murphy, Caroline
AU - Kelly, Joanna
PY - 2017/12/28
Y1 - 2017/12/28
N2 - Background: People with psychosis have a reduced life expectancy of 10-20years, largely due to cardiovascular disease. This trial aimed to determine the effectiveness of a modular health promotion intervention (IMPaCT Therapy) in improving health and reducing cardiovascular risk in psychosis. Methods: A multicentre, two arm, parallel cluster RCT was conducted across five UK mental health NHS trusts. Community care coordinators (CC) were randomly assigned to training and supervision in delivering IMPaCT Therapy or treatment as usual (TAU) to current patients with psychosis (cluster). The primary outcome was the physical and mental health subscales of the Short form-36 (SF-36) questionnaire. Results: Of 104 care coordinators recruited, 52 (with 213 patients) were randomised to deliver IMPaCT therapy and 52 (with 193 patients) randomised to TAU. Of 406 patients, 318 (78%) and 301 (74%) attended 12- and 15-month follow-up respectively. IMPaCT therapy showed no significant effect on the physical or mental health component SF-36 scores versus TAU at 12 or 15months. No effect was observed for cardiovascular risk indicators, except for HDL cholesterol, which improved more with IMPACT therapy than TAU (Treatment effect (95% CI); 0.085 (0.007 to 0.16); p= 0.034). The 22% of patients who received >180min of IMPACT Therapy in addition to usual care achieved a greater reduction in waist circumference than did controls, which was clinically significant. Conclusion: Training and supervising community care coordinators to use IMPaCT therapy in patients with psychosis is insufficient to significantly improve physical or mental health quality of life. The search for effective, pragmatic interventions deliverable in health care services continues. Trial registration: The trial was retrospectively registered with ISRCTN registry on 23/4/2010 at ISRCTN58667926 ; recruitment started on 01/03/2010 with first randomization on 09.08.2010 ISRCTN58667926.
AB - Background: People with psychosis have a reduced life expectancy of 10-20years, largely due to cardiovascular disease. This trial aimed to determine the effectiveness of a modular health promotion intervention (IMPaCT Therapy) in improving health and reducing cardiovascular risk in psychosis. Methods: A multicentre, two arm, parallel cluster RCT was conducted across five UK mental health NHS trusts. Community care coordinators (CC) were randomly assigned to training and supervision in delivering IMPaCT Therapy or treatment as usual (TAU) to current patients with psychosis (cluster). The primary outcome was the physical and mental health subscales of the Short form-36 (SF-36) questionnaire. Results: Of 104 care coordinators recruited, 52 (with 213 patients) were randomised to deliver IMPaCT therapy and 52 (with 193 patients) randomised to TAU. Of 406 patients, 318 (78%) and 301 (74%) attended 12- and 15-month follow-up respectively. IMPaCT therapy showed no significant effect on the physical or mental health component SF-36 scores versus TAU at 12 or 15months. No effect was observed for cardiovascular risk indicators, except for HDL cholesterol, which improved more with IMPACT therapy than TAU (Treatment effect (95% CI); 0.085 (0.007 to 0.16); p= 0.034). The 22% of patients who received >180min of IMPACT Therapy in addition to usual care achieved a greater reduction in waist circumference than did controls, which was clinically significant. Conclusion: Training and supervising community care coordinators to use IMPaCT therapy in patients with psychosis is insufficient to significantly improve physical or mental health quality of life. The search for effective, pragmatic interventions deliverable in health care services continues. Trial registration: The trial was retrospectively registered with ISRCTN registry on 23/4/2010 at ISRCTN58667926 ; recruitment started on 01/03/2010 with first randomization on 09.08.2010 ISRCTN58667926.
KW - Health promotion intervention
KW - Mortality
KW - Psychosis
KW - Quality of life
KW - Schizophrenia
UR - http://www.scopus.com/inward/record.url?scp=85039738760&partnerID=8YFLogxK
U2 - 10.1186/s12888-017-1571-0
DO - 10.1186/s12888-017-1571-0
M3 - Article
AN - SCOPUS:85039738760
SN - 1471-244X
VL - 17
JO - BMC Psychiatry
JF - BMC Psychiatry
IS - 1
M1 - 413
ER -