- ICH GCP
- Registro de ensayos clínicos de EE. UU.
- Ensayo clínico NCT02160249
RISE (Rehabilitation Intervention for People With Schizophrenia in Ethiopia) (RISE)
RISE (Rehabilitation Intervention for People With Schizophrenia in Ethiopia): a Cluster-randomised Trial
Descripción general del estudio
Estado
Condiciones
Intervención / Tratamiento
Descripción detallada
This is a cluster randomised trial set in rural Ethiopia with kebeles (villages) as the unit of randomisation. 54 kebeles will be included. 27 will be randomly allocated to the intervention arm (Facility based care (FBC) + Community-based Rehabilitation (CBR)) and 27 randomly allocated to the control arm (FBC alone).
The aim is to determine whether CBR + FBC is superior to FBC alone in reducing disability related to schizophrenia, measured by the WHO Disability Assessment Schedule version 2.0 (WHODAS 2.0) at 6 and 12 months.
Tipo de estudio
Inscripción (Actual)
Fase
- No aplica
Contactos y Ubicaciones
Ubicaciones de estudio
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Addis Ababa, Etiopía
- Department of Psychiatry, College of Health Sciences, Addis Ababa University
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Criterios de participación
Criterio de elegibilidad
Edades elegibles para estudiar
Acepta Voluntarios Saludables
Géneros elegibles para el estudio
Descripción
Inclusion Criteria:
- Age ≥18 years
- Diagnosis of schizophrenia spectrum disorder (schizophrenia, schizoaffective disorder or schizophreniform disorder) using (DSM-IV) criteria
- Evidence of severe, enduring or disabling illness
- Resident in kebele for >6 months and no immediate plans to leave the kebele
- Has a primary caregiver who is willing to participate in the study
Exclusion Criteria:
- No specific criteria
Plan de estudios
¿Cómo está diseñado el estudio?
Detalles de diseño
- Propósito principal: Cuidados de apoyo
- Asignación: Aleatorizado
- Modelo Intervencionista: Asignación de un solo grupo
- Enmascaramiento: Único
Armas e Intervenciones
Grupo de participantes/brazo |
Intervención / Tratamiento |
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Experimental: Community-based rehabilitation and facility based care
Community-based rehabilitation is delivered to participants and their caregivers at their home by a specialist CBR worker. It comprises psychoeducation, adherence support, rehabilitation (including self-care and social skills), family support groups and accessing existing community organisations. It also involves community awareness raising and education and mobilisation of community leaders. Facility based care (usual care) consists of anti-psychotic medication prescribed by a nurse or clinical officer in a health centre and basic psycho-education. |
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Comparador activo: Facility-based care
Facility based care (usual care) consists of anti-psychotic medication prescribed by a nurse or clinical officer in a health centre and basic psycho-education.
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¿Qué mide el estudio?
Medidas de resultado primarias
Medida de resultado |
Periodo de tiempo |
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Disability (36-item WHODAS (World Health Organisation Disability Assessment Schedule) 2.0)
Periodo de tiempo: 12 months
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12 months
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Medidas de resultado secundarias
Medida de resultado |
Medida Descripción |
Periodo de tiempo |
---|---|---|
Symptom severity (Brief Psychiatric Rating Scale- Expanded version (BPRS-E))
Periodo de tiempo: 6 and 12 months
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6 and 12 months
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Clinical Global Impression (CGI)
Periodo de tiempo: 6 and 12 months
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6 and 12 months
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Relapse (Longitudinal Interval Follow up Evaluation: DSM-IV version (LIFE))
Periodo de tiempo: 6 and 12 months
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6 and 12 months
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Disability (36-item WHODAS 2.0)
Periodo de tiempo: 6 months
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6 months
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Functioning (indigenous functioning scale)
Periodo de tiempo: 6 and 12 months
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Scale is currently under development.
It is being designed and validated to measure functioning in people with severe mental illness in rural Ethiopia.
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6 and 12 months
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Economic activity of patient (employment, income and household work)
Periodo de tiempo: 6 and 12 months
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Section includes current occupation (categories), employment status (categories), typical income (specific amount).
Section also includes questions adapted from the WHO-DAS 12 and 36 relating to problems doing usual work task both generally and as a result of their mental illness (likert scale)
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6 and 12 months
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Medication adherence (4 item Morisky Medication Adherence Scale)
Periodo de tiempo: 6 and 12 months
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6 and 12 months
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Engagement with facility based care
Periodo de tiempo: 6 and 12 months
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Potential mediator
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6 and 12 months
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Proportion with human rights problems (chaining or restraint)- self-reported
Periodo de tiempo: 6 and 12 months
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The outcome is the proportion chained, restrained or confined within last one month.
Additional data on who perpetrated the chaining i.e. traditional healer/ family member will be collected.
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6 and 12 months
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Nutritional status (BMI)
Periodo de tiempo: 6 and 12 months
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6 and 12 months
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Serious adverse events
Periodo de tiempo: 6 and 12 months
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6 and 12 months
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Economic activity of caregiver
Periodo de tiempo: 6 and 12 months
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Section includes current occupation (categories), employment status (categories), typical income (specific amount).
Section also includes questions adapted from the WHO-DAS 12 and 36 relating to problems doing usual work tasks (likert scale).
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6 and 12 months
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Caregiver burden (WHO Family Interview Schedule Impact section)
Periodo de tiempo: 6 and 12 months
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6 and 12 months
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Caregiver depression (PHQ9 +1)
Periodo de tiempo: 6 and 12 months
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6 and 12 months
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Patient medication adherence
Periodo de tiempo: 6 and 12 months
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6 and 12 months
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Proportion with human rights problems (chaining or restraint)- Caregiver-reported
Periodo de tiempo: 6 and 12 months
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Caregiver to report presence of human rights problems relating to patient.
The outcome is the proportion chained, restrained or confined within last one month.
Additional data on who perpetrated the chaining i.e. traditional healer/ family member will be collected.
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6 and 12 months
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Otras medidas de resultado
Medida de resultado |
Medida Descripción |
Periodo de tiempo |
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Discrimination (DISC-12)
Periodo de tiempo: 6 and 12 months
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Potential mediator
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6 and 12 months
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Health service use and costs
Periodo de tiempo: 6 and 12 months
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Potential mediator
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6 and 12 months
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Depression (PHQ-9+1)
Periodo de tiempo: 6 and 12 months
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Potential confounder
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6 and 12 months
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Access/ adherence to CBR and reasons for non-adherence
Periodo de tiempo: 6 and 12 months
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Potential mediator
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6 and 12 months
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Social support (OSLO-3)
Periodo de tiempo: 6 and 12 months
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Potential mediator
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6 and 12 months
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Stigma and discrimination (WHO Family Interview Schedule Stigma section)
Periodo de tiempo: 6 and 12 months
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6 and 12 months
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Colaboradores e Investigadores
Patrocinador
Colaboradores
Investigadores
- Investigador principal: Mary De Silva, PhD MSc, London School of Hygiene and Tropical Medicine
- Investigador principal: Abebaw Fekadu, Addis Ababa University Department of Psychiatry
Publicaciones y enlaces útiles
Publicaciones Generales
- Asher L, Birhane R, Weiss HA, Medhin G, Selamu M, Patel V, De Silva M, Hanlon C, Fekadu A. Community-based rehabilitation intervention for people with schizophrenia in Ethiopia (RISE): results of a 12-month cluster-randomised controlled trial. Lancet Glob Health. 2022 Apr;10(4):e530-e542. doi: 10.1016/S2214-109X(22)00027-4. Erratum In: Lancet Glob Health. 2022 Jun;10(6):e797.
- Asher L, Fekadu A, Teferra S, De Silva M, Pathare S, Hanlon C. "I cry every day and night, I have my son tied in chains": physical restraint of people with schizophrenia in community settings in Ethiopia. Global Health. 2017 Jul 11;13(1):47. doi: 10.1186/s12992-017-0273-1.
- Asher L, De Silva M, Hanlon C, Weiss HA, Birhane R, Ejigu DA, Medhin G, Patel V, Fekadu A. Community-based Rehabilitation Intervention for people with Schizophrenia in Ethiopia (RISE): study protocol for a cluster randomised controlled trial. Trials. 2016 Jun 24;17(1):299. doi: 10.1186/s13063-016-1427-9.
- De Silva MJ, Breuer E, Lee L, Asher L, Chowdhary N, Lund C, Patel V. Theory of Change: a theory-driven approach to enhance the Medical Research Council's framework for complex interventions. Trials. 2014 Jul 5;15:267. doi: 10.1186/1745-6215-15-267.
Fechas de registro del estudio
Fechas importantes del estudio
Inicio del estudio
Finalización primaria (Actual)
Finalización del estudio (Actual)
Fechas de registro del estudio
Enviado por primera vez
Primero enviado que cumplió con los criterios de control de calidad
Publicado por primera vez (Estimar)
Actualizaciones de registros de estudio
Última actualización publicada (Actual)
Última actualización enviada que cumplió con los criterios de control de calidad
Última verificación
Más información
Términos relacionados con este estudio
Palabras clave
Términos MeSH relevantes adicionales
Otros números de identificación del estudio
- 7035
- 100142/Z/12/Z (Otro número de subvención/financiamiento: Wellcome Trust)
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