Table 2.
Electronic devices
| Citation | Beebe et al29 | Granholm et al42 | Montes et al43 | Pijnenborg et al44 | Španiel et al45 | Stip et al46 |
|---|---|---|---|---|---|---|
| Design type | RCT | Quasi-experimental; pilot study | RCT open-label, multicenter trial | Quasi-experimental waiting list controlled trial; random assignment | RCT 1-year prospective, parallel-group, double-blind study | RCT |
| Intervention description | TIPS Weekly telephone calls for 3 months Focus: problem solving, coping strategies, reminders to take medications |
3 sets of 4 text messages sent via mobile phone, 6 days per week for 12 weeks – CBT format Focus: medication adherence, socialization, AH |
Intervention group = daily reminders for 3 months via text message (SMS) to take their medication Control group = no text reminders to take medications |
6 weekly psychoeducation group sessions with 5–7 patients Weeks 1–2 = baseline goals set (A1) 3 weeks = reminder texts about adherence + usual care = (B) Last 3 weeks during intervention = daily goals achieved 3 weeks postintervention = number of daily goals remeasured =(A2) |
Text message sent via computer program: ITAREPS 1 time/week Active group prodromal psychotic symptoms via weekly ALERT emails PIRE = triggered clinician to increase antipsychotic medication dose Active group = used ITAREPS and EWSQ-10P/EWSQ-10FM + usual treatment Control group = usual treatment |
3 visits: baseline, 6 weeks, and 8 weeks to measure impact of DoPill’s® (electronic pill dispenser) impact on medication adherence and psychiatric symptoms |
| Data collection time points | Baseline and monthly for 3 months | Baseline and 12 weeks | Baseline, 3 months, and 6-months | Intervention group: A1 + B + A2: A1 = baseline phase, B = intervention phase, A2 = follow-up phase Controls: A1 + A0 + B + A2 (A0 = extra baseline condition to control for passing time) |
Baseline, 6 months, and 12 months (end of study) | Baseline, 6 weeks, and 8 weeks |
| Sample | TIPS =15 TAU =14 |
n=55 | SMS =100 patients Controls =154 patients |
n=62 | Intervention =75 Controls =71 |
Experimental group =26 Control group =21 47 total completed study |
| Measures | Pill counts | PANSS BDI-II ILSS |
MAQ DAI SUMD EQ-5D CGI-SCH CGI-SI-DC |
PANSS SFS SCMTS |
CGI-S and CGI-I Hayward MCRS GAF PIRE detected by ITAREPS |
BARS PANSS DoPill® electronic/digital report (frequency) Antipsychotic Adherence Ratio |
| Findings | TIPS: 80% adherence to psychiatric medications; 33% adherence to nonpsychiatric medications TAU: 60.1% adherence to psychiatric medications; 22% adherence to nonpsychiatric medications Significantly higher adherence in TIPS group vs TAU group |
Significant improvement in medication adherence for those living independently; improved social functioning; reduced severity of AH | Significantly reduced MAQ score with SMS reminders vs controls at 3 months (25% versus 17.5%) at 6 months, maintained MAQ score change from baseline |
Overall % of goal-achievement =47% across patients, (SD =27.9%) and increased with text prompting =62% (SD =20.1%, returned to baseline levels without prompts =40% (SD =31.7%); Medication adherence = 57% at baseline (A1), 65% at intervention phase (B), and 48% at follow-up (A2) | No significant difference in medication adherence between groups | 46% non-adherent; Baseline adherent patientshad significantly > adherence vs non-adherent patients over 6-weeks via BARS measures; ie, Mean AAR 67% after 6-weeks; Proportion of patients with <70% and <90% AAR =46% and 54% |
Abbreviations: AAR, antipsychotic adherence ratio; AH, auditory hallucinations; BARS, Brief Adherence Rating Scale; BDI-II, Beck Depression Inventory-Second Edition; CBT, cognitive–behavioral therapy; CGI-I, Clinical Global Impression Scale-Improvement; CGI-S, Clinical Global Impression Scale-Severity; CGI-SCH, Clinical Global Impression Scale-Schizophrenia; CGI-SI-DC, Clinical Global Impression-Severity of Illness and Degree of Change; CL, confidence limit; DAI, Drug Attitude Inventory; EQ-5D, EuroQol; EWSQ-10FM, 10-item Early Warning Signs Questionnaire (Family Member); EWSQ-10P, 10-item Early Warning Signs Questionnaire (Patient); GAF, Global Assessment of Functioning; ILSS, Independent Living Skills Survey; ITAREPS, Information Technology-Aided Program of Relapse Prevention in Schizophrenia; MAQ, Medication Adherence Questionnaire; MCRS, Medication Compliance Rating Scale; PANSS, Positive and Negative Syndrome Scale; PIRE, pharmacological intervention requiring event; RCT, randomized controlled trial; SCMTS, Short Client Motivation for Therapy Scale; SD, standard deviation; SFS, Social Functioning Scale; SMS, short message service; SUMD, Scale to Assess Unawareness of Mental Disorder; TAU, treatment as usual; TIPS, telephone intervention problem-solving.