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

Abstract

IntroductionSchizophrenia 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/analysisThe community-based LEAN has four parts: (1) Lay 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 Award 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 disseminationUniversity 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 numberChiCTR-ICR-15006053; Pre-results.

The association between a free medicine program and functioning in people with schizophrenia: a cross-sectional study in Liuyang, China

“…However, better refill adherence alone was not associated with better functional outcomes in this study. Comprehensive approaches may be needed to address patient preferences, unwanted side effects, suboptimal treatments and other rehabilitative needs (Xu et al, 2016(Xu et al, , 2019. Local support and implementation are vital to complement the national program.…”

Pencegahan Kekambuhan Klien Skizofrenia Berbasis Mobile Apps dan Mobile Web: Systematic Review

“…No Penulis/negara Metode Kondisi N Nama aplikasi/web Fitur aplikasi/web dan program intervensi 1 Xu D et al (19) Cina Fitur data demografi klien Fitur randomisasi responden berdasarkan data demografi, hasil randomisasi akan dikirimkan via email ke responden Fitur pengisian kuesioner Early Warning Sign (EWS) melalui telepon genggam klien dan keluarga Apabila hasil kuesioner menunjukkan adanya keparahan gejala maka email secara otomatis akan terkirim ke petugas yang merawat Klien dianjurkan mengunjungi pelayanan kesehatan dan akan diberikan tambahan terapi 3 Gottlieb JD et al (21) USA Fitur pengkajian early warning sign pada kekambuhan untuk menilai kekambuhan pada klien yang mendapatkan intervensi 1 tahun pengurangan dosis terapi antipsikotik 9 Kidd SA et al (27) Kanada (31) Cina…”

“…Hasil penelitian menunjukkan adanya peningkatan kepatuhan minum obat dan pengurangan tanda dan gejala skizofrenia. (19) Variabel kepatuhan minum obat merupakan faktor risiko kekambuhan. Peningkatan kepatuhan minum obat akan berdampak terhadap pengurangan angka kekambuhan.…”

“…Aplikasi ini melakukan pemantauan secara berkala tanda-tanda awal kekambuhan dan efek samping obat dengan cara mengirimkan ceklist tanda dana gejala kekambuhan kepada klien dan LHS. (19,31) Evaluasi penting dilakukan secara berkala terhadap tanda dan gejala kekambuhan agar dapat ditentukan sesegera mungkin intervensi yang tepat seandainya muncul tanda-tanda kekambuhan.…”

“…Dokter setempat selanjutnya akan melakukan asesmen tingkat keparahan gejala kemudian klien akan dirujuk ke rumah sakit untuk mendapatkan penanganan selanjutnya. (19,31) Fitur integrasi yang disediakan oleh aplikasi App4Independence hampir sama dengan LEAN dimana data kondisi kesehatan mental klien terintegrasi secara langsung dengan sistem informasi kesehatan sehingga petugas kesehatan dapat memantau keadaan klien dari jarak jauh. (27) M-Resist menggunakan web based platform sebagai alat untuk mengumpulkan data klien, dan melakukan komunikasi dan koordinasi dengan klien dan petugas kesehatan lainnya.…”