Effectiveness of Information Technology Aided Relapse Prevention Programme in Schizophrenia excluding the effect of user adherence: A randomized controlled trial

• Published in: Schizophrenia research 2013-10, Vol.150 (1), p.240-244
• Main Authors: Komatsu, Hideki, Sekine, Yoshimoto, Okamura, Naoe, Kanahara, Nobuhisa, Okita, Kyoji, Matsubara, Saburo, Hirata, Toyoaki, Komiyama, Tokutaro, Watanabe, Hiroyuki, Minabe, Yoshio, Iyo, Masaomi
• Format: Article
• Language: English
• Subjects: Adult; Adult and adolescent clinical studies; Antipsychotic Agents - therapeutic use; Biological and medical sciences; Female; Hospitalization; Humans; Information technology; ITAREPS; Japan; Male; Medical Informatics - methods; Medical sciences; Middle Aged; Outpatients; Patient Readmission - statistics & numerical data; Prospective Studies; Psychiatric Status Rating Scales; Psychiatry; Psychology. Psychoanalysis. Psychiatry; Psychopathology. Psychiatry; Psychoses; Relapse prevention; Schizophrenia; Schizophrenia - therapy; Secondary Prevention; Statistics, Nonparametric; Visiting nurse
• ISSN: 0920-9964; 1573-2509
• DOI: 10.1016/j.schres.2013.08.007

Abstract Background A relapse prevention program called the Information Technology Aided Relapse Prevention Programme in Schizophrenia (ITAREPS) has been developed and is reported to be highly effective. However the effectiveness was influenced by user adherence to the protocol of the program, the exact effectiveness and the role of the ITAREPS have been partially uncertain. Objective The purpose of this study is to evaluate the effectiveness of the ITAREPS excluding the effect of user adherence to the protocol of the program. Method We attempted to perform a randomized controlled trial by the devised method with visiting nurse service. Outpatients with schizophrenia were randomized to the ITAREPS (n = 22) or control group (n = 23) and were observed for 12 months. Results The risk of rehospitalization was reduced in the ITAREPS group (2 [9.1%]) compared with the control group (8 [34.8%]) (hazard ratio = 0.21, 95% CI 0.04–0.99, p = 0.049; number needed to treat (NNT) = 4, 95% CI 2.1–35.5). The mean number of inpatient days was significantly lower in the ITAREPS group (18.5 days) compared with the control group (88.8 days) ( p = 0.036). The ratio of the number of rehospitalizations to that of relapses was significantly lower ( p = 0.035) and the mean change in total BPRS scores at relapse from baseline was significantly less in the ITAREPS group ( p = 0.019). Conclusions The relapse prevention effectiveness of the ITAREPS was high, and we confirmed that the ITAREPS, i.e., detecting signs of relapse and increasing medication during the warning state, is an effective intervention during the early stages of relapse.