Patient and relative education in community psychiatry; A randomized trial regarding it’s usefulness

Merinder, Lars; Viuff, Anne Grethe; Laugesen, Henriette; Clemmensen, Kim Katrine Bjerring; Misfelt, S; Espensen, B.

doi:10.1016/s0924-9338(99)80160-6

Cited by 1 publication

(8 citation statements)

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“…Medium term GAF/GAS data included four RCTs and results favoured standard care group (n = 321, MD −5.44 CI −8.51 to −2.38), as does the long term GAS outcome at two years’ follow-up (MD −6.70 CI −13.38 to −0.02). Short-term outcome data of the same scales were from one small trial (Brief - Group 1999) and were not significant (MD −2.64 CI −12.74 to 7.46). SLOF data came from one small trial (Standard - Group 2007), and both short-term (MD 23.60 CI 11.88 to 35.32) and medium-term (MD 46.40 CI 34.45 to 58.35) outcomes favour the psychoeducation group.…”

Section: Resultsmentioning

confidence: 98%

“…Only 11 of the included studies described randomisation method. Two studies were randomised by independent institutions (Brief - Group 1995; Brief - Group 1999); five studies used random number table (Brief - Individual 1996; Standard - Group 2006; Standard - Individual 03c; Unclear - Both 2007; 2008); one study drew lots (Standard -Individual 03b); one study used tossing a coin to randomise (Brief - Group 2007a); one study used block randomisation (Standard - Unclear 1996) and one study used computer generated cards (Standard - Both 1996) - this is also the only study that described allocation concealment (concealed with sealed envelop). Blinding was generally not described.…”

Section: Resultsmentioning

confidence: 99%

“…One trial did not use blinding (Brief - Individual 1996). Four other studies had some of their outcomes assessed single blind, but not for all outcomes (Brief - Group 1995; Brief - Group 1999; Standard - Group 1988; Standard - Individual 93). Blinding method was not stated in the other 35 included studies.…”

Section: Resultsmentioning

confidence: 99%

“…Seven studies were stated to have used single (assessor) blinding (Brief - Group 1999; Standard - Both 1996; Standard - Group 1988; Standard - Group 2006; Brief - Group 2007; Standard - Individual 93; Standard - Unclear 1996). One trial was double blind (Standard - Individual 03c) and one open label (Brief - Individual 1996).…”

Section: Resultsmentioning

confidence: 99%

“…Only Brief - Group 1999 reported on patients and relatives’ satisfaction using the VSS scale. Most data indicated an equivocal effect between groups.…”

Section: Discussionmentioning

confidence: 99%

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Psychoeducation for schizophrenia

Xia

Merinder

Belgamwar

2011

Cochrane Database of Systematic Reviews

335

166

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Background Schizophrenia can be a severe and chronic illness characterised by lack of insight and poor compliance with treatment. Psychoeducational approaches have been developed to increase patients’ knowledge of, and insight into, their illness and its treatment. It is supposed that this increased knowledge and insight will enable people with schizophrenia to cope in a more effective way with their illness, thereby improving prognosis. Objectives To assess the effects of psychoeducational interventions compared with standard levels of knowledge provision. Search methods We searched the Cochrane Schizophrenia Group Trials Register (February 2010). We updated this search November 2012 and added 27 new trials to the awaiting assessment section. Selection criteria All relevant randomised controlled trials focusing on psychoeducation for schizophrenia and/or related serious mental illnesses involving individuals or groups. We excluded quasi-randomised trials. Data collection and analysis At least two review authors extracted data independently from included papers. We contacted authors of trials for additional and missing data. We calculated risk ratios (RR) and 95% confidence intervals (CI) of homogeneous dichotomous data. We used a fixed-effects model for heterogeneous dichotomous data. Where possible we also calculated the numbers needed to treat (NNT), as well as weighted means for continuous data. Main results This review includes a total of 5142 participants (mostly inpatients) from 44 trials conducted between 1988 and 2009 (median study duration ~ 12 weeks, risk of bias - moderate). We found that incidences of non-compliance were lower in the psychoeducation group in the short term (n = 1400, RR 0.52 CI 0.40 to 0.67, NNT 11 CI 9 to 16). This finding holds for the medium and long term. Relapse appeared to be lower in psychoeducation group (n = 1214, RR 0.70 CI 0.61 to 0.81, NNT 9 CI 7 to 14) and this also applied to readmission (n = 206, RR 0.71 CI 0.56 to 0.89, NNT 5 CI 4 to 13). Scale-derived data also suggested that psychoeducation promotes better social and global functioning. In the medium term, treating four people with schizophrenia with psychoeducation instead of standard care resulted in one additional person showing a clinical improvement. Evidence suggests that participants receiving psychoeducation are more likely to be satisfied with mental health services (n = 236, RR 0.24 CI 0.12 to 0.50, NNT 5 CI 5 to 8) and have improved quality of life. Authors’ conclusions Psychoeducation does seem to reduce relapse, readmission and encourage medication compliance, as well as reduce the length of hospital stay in these hospital-based studies of limited quality. The true size of effect is likely to be less than demonstrated in this review - but, nevertheless, some sort of psychoeducation could be clinically effective and potentially cost beneficial. It is not difficult to justify better, more applicable, research in this area aimed at fully investigating the effects of this promising approach. No...

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Section: Resultsmentioning

confidence: 98%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

“…Only Brief - Group 1999 reported on patients and relatives’ satisfaction using the VSS scale. Most data indicated an equivocal effect between groups.…”

Section: Discussionmentioning

confidence: 99%

See 3 more Smart Citations