Mobile.net: Mobile Telephone Text Messages to Encourage Adherence to Medication and to Follow up With People With Psychosis: Methods and Protocol for a Multicenter Randomized Controlled Two-Armed Trial

Abstract

BackgroundSchizophrenia is a high-cost, chronic, serious mental illness. There is a clear need to improve treatments and expand access to care for persons with schizophrenia, but simple, tailored interventions are missing.ObjectiveTo evaluate the impact of tailored mobile telephone text messages to encourage adherence to medication and to follow up with people with psychosis at 12 months.MethodsMobile.Net is a pragmatic randomized trial with inpatient psychiatric wards allocated to two parallel arms. The trial will include 24 sites and 45 psychiatric hospital wards providing inpatient care in Finland. The participants will be adult patients aged 18–65 years, of either sex, with antipsychotic medication (Anatomical Therapeutic Chemical classification 2011) on discharge from a psychiatric hospital, who have a mobile phone, are able to use the Finnish language, and are able to give written informed consent to participate in the study. The intervention group will receive semiautomatic system (short message service [SMS]) messages after they have been discharged from the psychiatric hospital. Patients will choose the form, content, timing, and frequency of the SMS messages related to their medication, keeping appointments, and other daily care. SMS messages will continue to the end of the study period (12 months) or until participants no longer want to receive the messages. Patients will be encouraged to contact researchers if they feel that they need to adjust the message in any way. At all times, both groups will receive usual care at the discretion of their team (psychiatry and nursing). The primary outcomes are service use and healthy days by 12 months based on routine data (admission to a psychiatric hospital, time to next hospitalization, time in hospital during this year, and healthy days). The secondary outcomes are service use, coercive measures, medication, adverse events, satisfaction with care, the intervention, and the trial, social functioning, and economic factors. Data will be collected 12 months after baseline. The outcomes are based on the national health registers and patients’ subjective evaluations. The primary analysis will be by intention-to-treat.Trial RegistrationInternational Standard Randomised Controlled Trial Number (ISRCTN): 27704027; http://www.controlled-trials.com/ISRCTN27704027 (Archived by WebCite at http://www.webcitation.org/69FkM4vcq)

Online, social media and mobile technologies for psychosis treatment: A systematic review on novel user-led interventions

“…For those studies including comparison groups control interventions comprised treatment as usual (TAU) (Glynn et al, 1990;Spaniel et al, 2008a;Rotondi et al, 2010;Yakirevitch et al, 2010;Spaniel et al, 2012) and videos and information about schizophrenia treatment (Steinwachs et al, 2011). Five studies were conducted in the United States (Han et al, 2008;Glynn et al, 2010;Rotondi et al, 2010;Steinwachs et al, 2011;Granholm et al, 2012;Gottlieb et al, 2013), 5 in Europe (Spaniel et al, 2008a;Anttila et al, 2012;Spaniel et al, 2012;Välimäki et al, 2012;van der Krieke et al, 2012), 1 in Australia (Alvarez-Jimenez et al, 2013) and 1 in Israel (Yakirevitch et al, 2010).…”

How connected are people with schizophrenia? Cell phone, computer, email, and social media use

“…Sims et al (2012) found that text message appointment reminders to a total of 2817 subjects was associated with a 25-28% reduction in missed outpatient clinic appointments. Välimäki et al (2012) described methodology for a 12 month trial of text messages about medications, appointment, and self-care for inpatients on antipsychotics. The use of Internet-enabled mobile devices and social networking technologies to promote exercise in subjects at a specialist first-episode psychosis treatment center is also being investigated.…”

“…Several previous studies have investigated the prevalence of cell phones, computers, and/or Internet use, as well as the acceptability and efficacy technology-based interventions in patients with schizophrenia (described in Table 1). Improved missed appointment rates, medication adherence, and prodromal and other symptom assessment have been shown in studies using SMN or text-based applications on cell phones for individuals with schizophrenia Ben-Zeev et al, 2014;Montes et al, 2012;Palmier-Claus et al, 2012Sims et al, 2012;Välimäki et al, 2012). Certain aspects and patterns of an Internet profile and SMN use could be related to schizophrenia spectrum disorders (Krishna et al, 2013).…”

Perceptions of treatment adherence among people with mental health problems and health care professionals

“…The research project ‘Mobile.Net’ (Välimäki et al . ) was conducted in psychiatric hospital organizations where the healthcare professionals worked.…”

“…The study is a part of the ‘Mobile.Net’ (ISRCTN: 27704027) project, evaluating the effects of text messages on improving patient adherence to treatment (Välimäki et al . ). While aiming to develop and evaluate the effects of a newly developed mobile intervention, we wanted first to ensure that this intervention will target patient focused real problems in treatment adherence (Russell et al .…”