Improving adherence in mental health service users with severe mental illness in South Africa: a pilot randomized controlled trial of a treatment partner and text message intervention vs. treatment as usual

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dc.contributor.authorSibeko, Goodman
dc.contributor.authorSibeko, Goodman
dc.contributor.authorMall, Sumaya
dc.contributor.authorWilliams-Ashman, Peter
dc.contributor.authorThornicroft, Graham
dc.contributor.authorSusser, Ezra S
dc.contributor.authorLund, Crick
dc.contributor.authorStein, Dan J
dc.contributor.authorMilligan, Peter D
dc.date.accessioned2017-12-04T12:47:11Z
dc.date.available2017-12-04T12:47:11Z
dc.date.issued2017-11-09
dc.date.updated2017-11-12T05:35:10Z
dc.description.abstractObjectives: Medication non-adherence is a significant problem in treatment of severe mental disorders and is associated with poor clinical outcomes and increased demand on services. Task-shifting interventions incorporating mobile health may improve adherence in mental health service users in low- and middle-income countries. Seventy-seven participants were recruited from a psychiatric hospital in Cape Town, with 42 randomized to receive the intervention and 35 to treatment as usual. Intervention pairs underwent treatment-partner contracting and psychoeducation, and received monthly text message reminders of clinic appointments. Primary outcomes were intervention acceptability and feasibility. Secondary outcome for efficacy were adherence to clinic visit; relapse; quality of life; symptomatic relief and medication adherence. Results: Treatment partner and psychoeducation components were acceptable and feasible. The text message component was acceptable but not feasible in its current form. Efficacy outcomes favoured the intervention but did not reach statistical significance. A treatment-partner intervention is acceptable and feasible in a low- and middle-income setting. Work is needed to ensure that additional components of such interventions are tailored to the local context. Appropriately powered efficacy studies are needed. Trial Registration PACTR PACTR201610001830190, Registered 21 October 2016 (Retrospectively registered)
dc.identifier.apacitationSibeko, G., Sibeko, G., Mall, S., Williams-Ashman, P., Thornicroft, G., Susser, E. S., ... Milligan, P. D. (2017). Improving adherence in mental health service users with severe mental illness in South Africa: a pilot randomized controlled trial of a treatment partner and text message intervention vs. treatment as usual. <i>BMC Research Notes</i>, http://hdl.handle.net/11427/26445en_ZA
dc.identifier.chicagocitationSibeko, Goodman, Goodman Sibeko, Sumaya Mall, Peter Williams-Ashman, Graham Thornicroft, Ezra S Susser, Crick Lund, Dan J Stein, and Peter D Milligan "Improving adherence in mental health service users with severe mental illness in South Africa: a pilot randomized controlled trial of a treatment partner and text message intervention vs. treatment as usual." <i>BMC Research Notes</i> (2017) http://hdl.handle.net/11427/26445en_ZA
dc.identifier.citationSibeko, G., Temmingh, H., Mall, S., Williams-Ashman, P., Thornicroft, G., Susser, E. S., Lund, C., Stein, D. J., & Milligan, P. D. (2017). Improving adherence in mental health service users with severe mental illness in South Africa: a pilot randomized controlled trial of a treatment partner and text message intervention vs. treatment as usual, BMC Research Notes. 2017 Nov 09;10(1):584.
dc.identifier.ris TY - Journal Article AU - Sibeko, Goodman AU - Sibeko, Goodman AU - Mall, Sumaya AU - Williams-Ashman, Peter AU - Thornicroft, Graham AU - Susser, Ezra S AU - Lund, Crick AU - Stein, Dan J AU - Milligan, Peter D AB - Objectives: Medication non-adherence is a significant problem in treatment of severe mental disorders and is associated with poor clinical outcomes and increased demand on services. Task-shifting interventions incorporating mobile health may improve adherence in mental health service users in low- and middle-income countries. Seventy-seven participants were recruited from a psychiatric hospital in Cape Town, with 42 randomized to receive the intervention and 35 to treatment as usual. Intervention pairs underwent treatment-partner contracting and psychoeducation, and received monthly text message reminders of clinic appointments. Primary outcomes were intervention acceptability and feasibility. Secondary outcome for efficacy were adherence to clinic visit; relapse; quality of life; symptomatic relief and medication adherence. Results: Treatment partner and psychoeducation components were acceptable and feasible. The text message component was acceptable but not feasible in its current form. Efficacy outcomes favoured the intervention but did not reach statistical significance. A treatment-partner intervention is acceptable and feasible in a low- and middle-income setting. Work is needed to ensure that additional components of such interventions are tailored to the local context. Appropriately powered efficacy studies are needed. Trial Registration PACTR PACTR201610001830190, Registered 21 October 2016 (Retrospectively registered) DA - 2017-11-09 DB - OpenUCT DO - 10.1186/s13104-017-2915-z DP - University of Cape Town J1 - BMC Research Notes LK - https://open.uct.ac.za PB - University of Cape Town PY - 2017 T1 - Improving adherence in mental health service users with severe mental illness in South Africa: a pilot randomized controlled trial of a treatment partner and text message intervention vs. treatment as usual TI - Improving adherence in mental health service users with severe mental illness in South Africa: a pilot randomized controlled trial of a treatment partner and text message intervention vs. treatment as usual UR - http://hdl.handle.net/11427/26445 ER - en_ZA
dc.identifier.urihttp://dx.doi.org/10.1186/s13104-017-2915-z
dc.identifier.urihttp://hdl.handle.net/11427/26445
dc.identifier.vancouvercitationSibeko G, Sibeko G, Mall S, Williams-Ashman P, Thornicroft G, Susser ES, et al. Improving adherence in mental health service users with severe mental illness in South Africa: a pilot randomized controlled trial of a treatment partner and text message intervention vs. treatment as usual. BMC Research Notes. 2017; http://hdl.handle.net/11427/26445.en_ZA
dc.language.isoen
dc.publisherBioMed Central
dc.publisher.departmentDepartment of Psychiatry and Mental Healthen_ZA
dc.publisher.facultyFaculty of Health Sciencesen_ZA
dc.publisher.institutionUniversity of Cape Town
dc.rights.holderThe Author(s)
dc.sourceBMC Research Notes
dc.source.urihttps://bmcresnotes.biomedcentral.com/
dc.subject.otherMental health
dc.subject.otherTask-shifting
dc.subject.otherTreatment partner
dc.subject.otherAdherence
dc.subject.otherText message
dc.subject.otherMobile health
dc.titleImproving adherence in mental health service users with severe mental illness in South Africa: a pilot randomized controlled trial of a treatment partner and text message intervention vs. treatment as usual
dc.typeJournal Article
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