- ICH GCP
- Registre américain des essais cliniques
- Essai clinique NCT02160249
RISE (Rehabilitation Intervention for People With Schizophrenia in Ethiopia) (RISE)
RISE (Rehabilitation Intervention for People With Schizophrenia in Ethiopia): a Cluster-randomised Trial
Aperçu de l'étude
Statut
Les conditions
Intervention / Traitement
Description détaillée
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.
Type d'étude
Inscription (Réel)
Phase
- N'est pas applicable
Contacts et emplacements
Lieux d'étude
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Addis Ababa, Ethiopie
- Department of Psychiatry, College of Health Sciences, Addis Ababa University
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Critères de participation
Critère d'éligibilité
Âges éligibles pour étudier
Accepte les volontaires sains
Sexes éligibles pour l'étude
La description
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 d'étude
Comment l'étude est-elle conçue ?
Détails de conception
- Objectif principal: Soins de soutien
- Répartition: Randomisé
- Modèle interventionnel: Affectation à un seul groupe
- Masquage: Seul
Armes et Interventions
Groupe de participants / Bras |
Intervention / Traitement |
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Expérimental: 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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Comparateur actif: 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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Que mesure l'étude ?
Principaux critères de jugement
Mesure des résultats |
Délai |
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Disability (36-item WHODAS (World Health Organisation Disability Assessment Schedule) 2.0)
Délai: 12 months
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12 months
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Mesures de résultats secondaires
Mesure des résultats |
Description de la mesure |
Délai |
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Symptom severity (Brief Psychiatric Rating Scale- Expanded version (BPRS-E))
Délai: 6 and 12 months
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6 and 12 months
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Clinical Global Impression (CGI)
Délai: 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))
Délai: 6 and 12 months
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6 and 12 months
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Disability (36-item WHODAS 2.0)
Délai: 6 months
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6 months
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Functioning (indigenous functioning scale)
Délai: 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)
Délai: 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)
Délai: 6 and 12 months
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6 and 12 months
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Engagement with facility based care
Délai: 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
Délai: 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)
Délai: 6 and 12 months
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6 and 12 months
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Serious adverse events
Délai: 6 and 12 months
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6 and 12 months
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Economic activity of caregiver
Délai: 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)
Délai: 6 and 12 months
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6 and 12 months
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Caregiver depression (PHQ9 +1)
Délai: 6 and 12 months
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6 and 12 months
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Patient medication adherence
Délai: 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
Délai: 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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Autres mesures de résultats
Mesure des résultats |
Description de la mesure |
Délai |
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Discrimination (DISC-12)
Délai: 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
Délai: 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)
Délai: 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
Délai: 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)
Délai: 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)
Délai: 6 and 12 months
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6 and 12 months
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Collaborateurs et enquêteurs
Collaborateurs
Les enquêteurs
- Chercheur principal: Mary De Silva, PhD MSc, London School of Hygiene and Tropical Medicine
- Chercheur principal: Abebaw Fekadu, Addis Ababa University Department of Psychiatry
Publications et liens utiles
Publications générales
- 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.
Dates d'enregistrement des études
Dates principales de l'étude
Début de l'étude
Achèvement primaire (Réel)
Achèvement de l'étude (Réel)
Dates d'inscription aux études
Première soumission
Première soumission répondant aux critères de contrôle qualité
Première publication (Estimation)
Mises à jour des dossiers d'étude
Dernière mise à jour publiée (Réel)
Dernière mise à jour soumise répondant aux critères de contrôle qualité
Dernière vérification
Plus d'information
Termes liés à cette étude
Mots clés
Termes MeSH pertinents supplémentaires
Autres numéros d'identification d'étude
- 7035
- 100142/Z/12/Z (Autre subvention/numéro de financement: Wellcome Trust)
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