- ICH GCP
- Amerikanska kliniska prövningsregistret
- Klinisk prövning NCT02160249
RISE (Rehabilitation Intervention for People With Schizophrenia in Ethiopia) (RISE)
RISE (Rehabilitation Intervention for People With Schizophrenia in Ethiopia): a Cluster-randomised Trial
Studieöversikt
Status
Intervention / Behandling
Detaljerad beskrivning
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.
Studietyp
Inskrivning (Faktisk)
Fas
- Inte tillämpbar
Kontakter och platser
Studieorter
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Addis Ababa, Etiopien
- Department of Psychiatry, College of Health Sciences, Addis Ababa University
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Deltagandekriterier
Urvalskriterier
Åldrar som är berättigade till studier
Tar emot friska volontärer
Kön som är behöriga för studier
Beskrivning
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
Studieplan
Hur är studien utformad?
Designdetaljer
- Primärt syfte: Stödjande vård
- Tilldelning: Randomiserad
- Interventionsmodell: Enskild gruppuppgift
- Maskning: Enda
Vapen och interventioner
Deltagargrupp / Arm |
Intervention / Behandling |
---|---|
Experimentell: 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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Aktiv komparator: 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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Vad mäter studien?
Primära resultatmått
Resultatmått |
Tidsram |
---|---|
Disability (36-item WHODAS (World Health Organisation Disability Assessment Schedule) 2.0)
Tidsram: 12 months
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12 months
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Sekundära resultatmått
Resultatmått |
Åtgärdsbeskrivning |
Tidsram |
---|---|---|
Symptom severity (Brief Psychiatric Rating Scale- Expanded version (BPRS-E))
Tidsram: 6 and 12 months
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6 and 12 months
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Clinical Global Impression (CGI)
Tidsram: 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))
Tidsram: 6 and 12 months
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6 and 12 months
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Disability (36-item WHODAS 2.0)
Tidsram: 6 months
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6 months
|
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Functioning (indigenous functioning scale)
Tidsram: 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)
Tidsram: 6 and 12 months
|
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)
Tidsram: 6 and 12 months
|
6 and 12 months
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Engagement with facility based care
Tidsram: 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
Tidsram: 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)
Tidsram: 6 and 12 months
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6 and 12 months
|
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Serious adverse events
Tidsram: 6 and 12 months
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6 and 12 months
|
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Economic activity of caregiver
Tidsram: 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)
Tidsram: 6 and 12 months
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6 and 12 months
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Caregiver depression (PHQ9 +1)
Tidsram: 6 and 12 months
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6 and 12 months
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Patient medication adherence
Tidsram: 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
Tidsram: 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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Andra resultatmått
Resultatmått |
Åtgärdsbeskrivning |
Tidsram |
---|---|---|
Discrimination (DISC-12)
Tidsram: 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
Tidsram: 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)
Tidsram: 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
Tidsram: 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)
Tidsram: 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)
Tidsram: 6 and 12 months
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6 and 12 months
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Samarbetspartners och utredare
Samarbetspartners
Utredare
- Huvudutredare: Mary De Silva, PhD MSc, London School of Hygiene and Tropical Medicine
- Huvudutredare: Abebaw Fekadu, Addis Ababa University Department of Psychiatry
Publikationer och användbara länkar
Allmänna publikationer
- 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.
Studieavstämningsdatum
Studera stora datum
Studiestart
Primärt slutförande (Faktisk)
Avslutad studie (Faktisk)
Studieregistreringsdatum
Först inskickad
Först inskickad som uppfyllde QC-kriterierna
Första postat (Uppskatta)
Uppdateringar av studier
Senaste uppdatering publicerad (Faktisk)
Senaste inskickade uppdateringen som uppfyllde QC-kriterierna
Senast verifierad
Mer information
Termer relaterade till denna studie
Nyckelord
Ytterligare relevanta MeSH-villkor
Andra studie-ID-nummer
- 7035
- 100142/Z/12/Z (Annat bidrag/finansieringsnummer: Wellcome Trust)
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