Table 4.
Miscellaneous support services
| Citation | Morken et al51 | Priebe et al52 | Valenstein et al53 | Velligan et al54 | Velligan et al33 |
|---|---|---|---|---|---|
| Design type | RCT | RCT with cluster randomization controlled trial of treatment teams | RCT with block-randomization of patients (experimental without double-blind) | 3-armed RCT | 3-armed RCT |
| Intervention description | IT =2 years of assertive outreach community treatment, family psychoeducation, social skills training/CBT | Patients on intervention teams who adhered ≤75% of the time 4 months prior to screening received financial incentive of $22/clinic visit to receive prescribed long-acting antipsychotic injection |
Intervention: Meds-Help = unit-dose medication packaging medication education | Pharm-CAT – tailored environmental supports and weekly home visits Med e-Monitor – prompts from an electronic device in the patient’s home; telephone contacts TAU |
Full-CAT – tailored environmental supports for independent living skills, social/role performance, medication adherence Pharm-CAT – tailored environmental supports for medication and appointment adherence only TAU |
| Data collection time points | Baseline, 12 months, 24 months | Baseline to 12-month endpoint | 12 months prior to enrollment (baseline), 0–6 months, and 6–12 months after enrollment | Baseline, 3 months, 6 months, 9 months | Baseline, 3 months, 6 months, 9 months, 12 months, 15 months |
| Sample | IT =30 Control =20 |
Intervention =78, control =63 | Meds-Help =58 TAU =60 |
Pharm-CAT =46 Med e-Monitor =46 TAU =45 |
Full-CAT =34 Pharm-CAT =32 TAU =29 |
| Measures | Medication Adherence (self, family and clinician reports) Camberwell Family Interview BPRS |
Medication adherence CGI DIALOG scale Satisfaction with medication |
Primary: MPR Secondary: PANSS QWBS CSQ |
Medication adherence SCID BPRS SOFAS Service use |
SCID Pill counts BPRS SOFAS Relapse Score |
| Findings | No significant differences in medication adherence between IT and ST Men more non-adherent than women |
Modest financial incentives improve adherence to LAI 12-month trial adherence: intervention group =85%, controls =71% Secondary outcome adherence of ≥95%: intervention group =28% controls =5% |
MPRs = Meds-Help group had significantly > MPRs at 6 months (Meds-Help MPR 0.91, UC MPR 0.64) and 12 months Meds-Help MPR 0.82, UC 0.62 (P<0.0001) |
Medication adherence – Pharm-CAT =90% Med e-Monitor =91% TAU =73% Both Pharm-CAT and Med e-Monitor significantly higher than TAU |
Medication adherence significantly higher in Full-CAT and Pharm-CAT groups compared to TAU; remained significantly higher after home visits stopped |
Abbreviations: BPRS, Brief Psychiatric Rating Scale; CGI, Clinical Global Impressions Scale; CBT, cognitive–behavioral therapy; CSQ, Client Satisfaction Questionnaire; Full-CAT, full cognitive adaptation training; IT, integrated treatment; LAI, long-acting injectable; MPR, medication possession ratio; PANSS, Positive and Negative Syndrome Scale; Pharm-CAT, cognitive adaptation training with medication education; QWBS, Quality of Well-Being Scale; RCT, randomized controlled trial; SCID, Structured Clinical Interview for Diagnosis; SOFAS, Social and Occupational Functioning Assessment Scale; ST, standard treatment; TAU, treatment as usual; UC, usual care.