Table 3. Analysis of Self-Management Intervention (SM) for people with severe mental illness compared to control (active or TAU) (random-effects model).
| Outcome | Time of data collection | Trials (k) | Participants SM/control (n) | Estimate | Summary of estimate [95% CI] | Z, p | Heterogeneity | ||
|---|---|---|---|---|---|---|---|---|---|
| Q test | I2 (%) | ||||||||
| Symptoms | (1) Total Symptoms | End of treatment | 17 | 912/1067 | SMD | -0.43 [-0.63, -0.22] | 4.12, p<.0001* | Q = 72.84, p<0.0001 | 78† |
| Follow-up | 13 | 676/844 | SMD | -0.88 [-1.19, -0.57] | 5.52, p<.0001* | Q = 82.69, p<0.0001 | 87† | ||
| Positive Symptoms | End of treatment | 8 | 372/507 | SMD | -0.22 [-0.51, 0.07] | 1.50, p= 0.13 | Q = 26.09, p=0.0005 | 73† | |
| Follow-up | 6 | 312/459 | SMD | -0.61 [-1.03, -0.19] | 2.86, p= 0.004* | Q= 33.27, p<0.0001 | 85† | ||
| Negative Symptoms | End of treatment | 9 | 457/590 | SMD | -0.26 [-0.47, -0.05] | 2.44, p= 0.01* | Q= 19.62, p= 0.01 | 59† | |
| Follow-up | 7 | 378/523 | SMD | -0.51 [-0.82, -0.21] | 3.28, p= 0.001* | Q= 26.50, p= 0.0002 | 77† | ||
| Affective Symptoms (Depression/Anxiety) | End of treatment | 5 | 230/222 | SMD | -0.26 [-0.51, -0.01] | 2.04, p = 0.04* | Q = 6.69, p= 0.15 | 40 | |
| Follow-up | 6 | 475/489 | SMD | -0.19 [-0.33, -0.04] | 2.43, p = 0.02* | Q = 5.91, p= 0.31 | 15 | ||
| Relapse | (2) Mean number of readmissions to acute care | End of treatment | 5 | 315/456 | SMD | -0.39 [-0.89, 0.11] | 1.52, p= 0.13 | Q = 38.72, p<0.0001 | 90† |
| Follow-up | 5 | 257/398 | SMD | -0.92 [-1.63, -0.21] | 2.53, p = 0.01* | Q = 57.74, p<0.0001 | 93† | ||
| Total number of patients in each group readmitted to acute care | End of treatment | 2 | 104/147 | RR | 0.84 [0.48, 1.46] | 0.63, p = 0.53 | Q = 0.72, p=0.40 | 0 | |
| Follow-up | 10 | 416/473 | RR | 0.75 [0.51, 1.08] | 1.54, p = 0.12 | Q =15.05, p = 0.09† | 40 | ||
| Length of admission to acute care | End of treatment | 6 | 359/543 | SMD | -0.26 [-0.50, -0.02] | 2.08, p= 0.04* | Q = 10.77, p= 0.03 | 63† | |
| Follow-up | 7 | 350/558 | SMD | -0.68 [-1.10, -0.25] | 3.12, p=0.002* | Q = 49.76, p<0.0001 | 88† | ||
| Recovery | (3) Recovery - Total | End of treatment | 11 | 507/506 | SMD | -0.62 [-1.03, -0.22] | 3.03, p= 0.002* | Q = 89.3, p<0.0001 | 89† |
| Follow-up | 7 | 543/591 | SMD | -0.81 [-1.40, -0.22] | 2.68, p = 0.007* | Q = 105.09 p<0.0001 | 94† | ||
| Recovery - Empowerment | End of treatment | 3 | 187/159 | SMD | -1.44 [-2.97, 0.08] | 1.86, p = 0.06 | Q = 44.89, p<0.0001 | 96† | |
| Follow-up | 2 | 278/260 | SMD | -0.25 [-0.43, -0.07] | 2.68, p = 0.007* | Q = 1.13, p = 0.29 | 12 | ||
| Recovery- Hope | End of treatment | 2 | 200/189 | SMD | -0.18 [-0.38, 0.01] | 1.81, p = 0.07 | Q= 0.52, p= 0.47 | 0 | |
| Follow-up | 3 | 487/480 | SMD | -0.24 [-0.46, -0.02] | 2.16, p = 0.03* | Q = 5.74, p = 0.06 | 65† | ||
| Recovery - Self-Efficacy | End of treatment | 4 | 322/279 | SMD | -0.38 [-0.62, -0.15] | 3.18, p = 0.001* | Q = 5.42, p= 0.14 | 45 | |
| Follow-up | 1 | 121/100 | SMD | -0.34 [-0.61, -0.07] | 2.50, p = 0.01* | N/A | N/A | ||
| Functioning | (4) Functioning | End of treatment | 15 | 884/1064 | SMD | -0.56 [-0.85, -0.28] | 3.90, p<0.0001* | Q =121.25, p<0.0001 | 88† |
| Follow-up | 14 | 805/1000 | SMD | -0.90 [-1.34, -0.45] | 3.97, p<0.0001* | Q = 237.9, p<0.0001 | 95† | ||
| QoL | (5) Quality of Life | End of treatment | 9 | 440/423 | SMD | -0.23 [-0.37, -0.10] | 3.38, p =0.0007* | Q = 7.83, p = 0.45 | 0 |
| Follow-up | 7 | 491/489 | SMD | -0.25 [-0.37, -0.12] | 3.84, p=0.0001* | Q =3.07, p = 0.80 | 0 | ||
*
Statistically significant finding (p<0.05)
†
Indicates high heterogeneity: I2 exceeds 50% and/or P value less than 0.10