Residual Effect of Texting to Promote Medication Adherence for Villagers with Schizophrenia in China: 18-Month Follow-up Survey After the Randomized Controlled Trial Discontinuation (Preprint)

• DOI: 10.2196/preprints.33628
• Publication Date: 2022-04-19T15:01:39Z
• Authors: Yiyuan Cai; Wenjie Gong; Wenjun He; Hua He; James P Hughes; Jane Simoni; Shuiyuan Xiao; Stephen Gloyd; Meijuan Lin; Xinlei Deng; Zichao Liang; Bofeng Dai; Jing Liao; Yuantao Hao; Dong Roman Xu
• Keywords: Discontinuation

<sec> <title>BACKGROUND</title> Reducing the treatment gap for mental health in low- and middle-income countries is a high priority. Even with treatment, adherence to antipsychotics rather low. Our integrated intervention package significantly improved medication within 6 months villagers schizophrenia resource-poor communities rural China. However, considering resource constraint, we need test whether effect of those behavior-shaping interventions may be maintained even after suspension intervention. </sec> <title>OBJECTIVE</title> The aim this study explore primary outcome other outcomes at an 18-month follow-up had been suspended. <title>METHODS</title> In 6-month randomized trial, 277 were receive either government community program (686 Program) or 686 Program plus Lay supporters, e-platform, award, integration (LEAN), which included supporters care supervision, e-platform access sending mobile SMS text messaging reminders education message, token gift positive behavior changes (eg, continuing taking medicine), integrating existing Program. After intervention, both groups received only 18 (phase 2). Outcomes phases antipsychotic adherence, functioning, symptoms, number rehospitalization, suicide, violent behaviors. functioning assessed home visit by trained assessors. We calculated past 30 days counting percentage dosages taken from November December 2018 unannounced home-based pill counts. was using World Health Organization Disability Assessment Schedule 2.0. symptoms evaluated Clinical Global Impression–Schizophrenia during their visits psychiatrists. Other routinely collected system. used intention-to-treat analysis, missing data dealt multiple imputation. generalized estimating equation model assess effects on symptoms. <title>RESULTS</title> phase 1, rehospitalization incidence significantly. 2, difference mean (adjusted 0.05, 95% CI −0.06 0.16; &lt;i&gt;P&lt;/i&gt;=.41; Cohen &lt;i&gt;d&lt;/i&gt; size=0.11) (relative risk 0.65, 0.32-1.33; &lt;i&gt;P&lt;/i&gt;=.24; needed treat 21.83, 8.30-34.69) no longer statistically significant, there improvement (&lt;i&gt;P&lt;/i&gt;≥.05). <title>CONCLUSIONS</title> simple community-based LEAN could not continually improve reduce people schizophrenia. inclined suggest that prompts necessary maintain schizophrenia, although cannot definitively exclude alternative interpretations.