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Mobile After-Care Support Intervention for Patients with Schizophrenia following Hospitalization

精神分裂症患者住院后的移动善后支持干预

基本信息

批准号：
9924664
负责人：
BRANDON A GAUDIANO
金额：
$ 22.78万
依托单位：
BUTLER HOSPITAL (PROVIDENCE, RI)
依托单位国家：
美国
项目类别：
财政年份：
2018
资助国家：
美国
起止时间：
2018-07-10 至 2022-04-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/9924664
关键词：
Acute Adherence Administrator Adult Aftercare Ambulatory Care Antipsychotic Agents Appointment Area Behavioral Car Phone Caring Cellular Phone Clinical Clinical Data Clinical Treatment Clinical Trials Cognitive Cognitive Therapy Communities Community Mental Health Centers Continuity of Patient Care Data Data Collection Development Discharge Plannings Disease Drops Ecological momentary assessment Effectiveness Enrollment Ensure Fostering Funding Future Goals Health Promotion Healthcare Systems Hospitalization Hospitals Inpatients Intervention Interview Link Literature Mental Health Morbidity - disease rate National Institute of Mental Health Oral Outcome Outpatients Partnership Practice Pathway interactions Patient Noncompliance Patients Pharmaceutical Preparations Phase Population Preparation Prevalence Preventive Intervention Process Provider Psyche structure Psychotic Disorders Public Health Quality of life Randomized Randomized Controlled Trials Recovery Research Research Support Risk Sampling Schizoaffective Disorders Schizophrenia Self Management Self-Help Devices Service delivery model Services Severities Strategic Planning Symptoms System Technology Testing Time Work attentional control base behavioral adherence brief intervention coping cost critical period design disability effectiveness testing effectiveness trial evidence base handheld mobile device high risk hospital readmission improved improved outcome in vivo innovation inpatient service medication compliance mobile application mortality new technology novel outpatient programs preference premature prototype psychosocial readmission rates recruit relapse risk response satisfaction self help service intervention societal costs symptom management tool treatment adherence treatment center treatment risk treatment services wasting

项目摘要

Schizophrenia and schizoaffective disorder are associated with disproportionately high societal costs related to treatment, disability, and morbidity/mortality. Patients' nonadherence to medications and psychosocial treatments undermine the long-term management of these illnesses, making it difficult to achieve improved quality of life and ultimate recovery. Patients are at particularly high risk of treatment gaps and poor coping during the transitional period from inpatient hospitalization to outpatient care. Our long-term goal is to improve the continuity of care for patients with psychosis by supporting a safer and more efficient transition from inpatient to outpatient services. Our objective, which is the next step in attaining this long-term goal and building on our previously funded work, is to examine the feasibility, acceptability, and preliminary efficacy of a mobile device-delivered app, called Mobile After-Care Support (MACS), to improve patients' self-coping and medication and appointment adherence following a hospitalization. We hypothesize that MACS, a response- adaptive mobile app using empirically-supported cognitive behavioral strategies for psychosis, will lead to increases in the target mechanisms of self-coping and medication/appointment adherence, which will produce improvements in symptoms, and secondarily functioning and rehospitalization rates. Thus, establishing MACS as a viable adjunctive treatment aid during the critical months immediately post-discharge will provide essential data on a pathway to improved outcomes in adults with psychosis. The aims of this proposal are: (1) to use an iterative process to refine a new mobile aftercare app by conducting an initial open trial (n=10); and (2) to conduct a pilot randomized controlled trial (n = 50) of MACS vs. a mobile app time and attention control condition to examine its preliminary effects. During the open trial, we also will collect qualitative data from local stakeholders (e.g., patients, clinicians, administrators) to improve the intervention in preparation for the randomized phase of the project and to establish clinicians' preferences for receiving clinical data from MACS. The sample will consist of 60 patients total with schizophrenia-spectrum disorders, recruited during an inpatient psychiatric hospitalization and transitioning to outpatient care at local community mental health centers. Patients will use MACS up to 4 months post-discharge, during which time we will longitudinally assess their usage and outcomes. The approach is innovative in that it departs from the status quo by targeting this high risk and understudied phase in the continuum of care and by delivering a brief intervention in real-time via an app on patients' mobile phones. Successful completion of the proposed project will contribute significant actionable data on the feasibility and acceptability of MACS and its initial effects on coping, treatment adherence, and subsequent clinical outcomes (symptoms, functioning, rehospitalization). Data from this project will inform the future large-scale testing of MACS as a simple and potentially disseminable tool to aid patients' re-entry into the community after being hospitalized for psychosis.

精神分裂症和分裂情感性障碍与不成比例的高社会成本相关

项目成果

期刊论文数量（2）

专著数量（0）

科研奖励数量（0）

会议论文数量（0）

专利数量（0）

Stakeholder perspectives on adjunctive mHealth services during transitions of care for patients with schizophrenia-spectrum disorders.

DOI：
10.1080/09638237.2022.2069693
发表时间：
2024-04
期刊：
JOURNAL OF MENTAL HEALTH
影响因子：
3.3
作者：
Moitra, Ethan;Park, Hyun Seon;Guthrie, Kate M.;Johnson, Jennifer E.;Peters, Gloria;Wittler, Ellen;Price, Lawrence H.;Gaudiano, Brandon A.
通讯作者：
Gaudiano, Brandon A.

Development and Initial Testing of an mHealth Transitions of Care Intervention for Adults with Schizophrenia-Spectrum Disorders Immediately Following a Psychiatric Hospitalization.