RISE (Rehabilitation Intervention for People With Schizophrenia in Ethiopia) (RISE)
RISE (Rehabilitation Intervention for People With Schizophrenia in Ethiopia): a Cluster-randomised Trial
調査の概要
状態
詳細な説明
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.
研究の種類
入学 (実際)
段階
- 適用できない
連絡先と場所
研究場所
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Addis Ababa、エチオピア
- Department of Psychiatry, College of Health Sciences, Addis Ababa University
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参加基準
適格基準
就学可能な年齢
健康ボランティアの受け入れ
受講資格のある性別
説明
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
研究計画
研究はどのように設計されていますか?
デザインの詳細
- 主な目的:支持療法
- 割り当て:ランダム化
- 介入モデル:単一グループの割り当て
- マスキング:独身
武器と介入
参加者グループ / アーム |
介入・治療 |
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実験的: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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アクティブコンパレータ: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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この研究は何を測定していますか?
主要な結果の測定
結果測定 |
時間枠 |
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Disability (36-item WHODAS (World Health Organisation Disability Assessment Schedule) 2.0)
時間枠:12 months
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12 months
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二次結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
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Symptom severity (Brief Psychiatric Rating Scale- Expanded version (BPRS-E))
時間枠:6 and 12 months
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6 and 12 months
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Clinical Global Impression (CGI)
時間枠: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))
時間枠:6 and 12 months
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6 and 12 months
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Disability (36-item WHODAS 2.0)
時間枠:6 months
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6 months
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Functioning (indigenous functioning scale)
時間枠: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)
時間枠: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)
時間枠:6 and 12 months
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6 and 12 months
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Engagement with facility based care
時間枠: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
時間枠: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)
時間枠:6 and 12 months
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6 and 12 months
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Serious adverse events
時間枠:6 and 12 months
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6 and 12 months
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Economic activity of caregiver
時間枠: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)
時間枠:6 and 12 months
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6 and 12 months
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Caregiver depression (PHQ9 +1)
時間枠:6 and 12 months
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6 and 12 months
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Patient medication adherence
時間枠: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
時間枠: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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その他の成果指標
結果測定 |
メジャーの説明 |
時間枠 |
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Discrimination (DISC-12)
時間枠: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
時間枠: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)
時間枠: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
時間枠: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)
時間枠: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)
時間枠:6 and 12 months
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6 and 12 months
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協力者と研究者
捜査官
- 主任研究者:Mary De Silva, PhD MSc、London School of Hygiene and Tropical Medicine
- 主任研究者:Abebaw Fekadu、Addis Ababa University Department of Psychiatry
出版物と役立つリンク
一般刊行物
- 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.
研究記録日
主要日程の研究
研究開始
一次修了 (実際)
研究の完了 (実際)
試験登録日
最初に提出
QC基準を満たした最初の提出物
最初の投稿 (見積もり)
学習記録の更新
投稿された最後の更新 (実際)
QC基準を満たした最後の更新が送信されました
最終確認日
詳しくは
本研究に関する用語
キーワード
その他の研究ID番号
- 7035
- 100142/Z/12/Z (その他の助成金/資金番号:Wellcome Trust)
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