Clinical effectiveness of a web-based peer-supported self-management intervention for relatives of people with psychosis or bipolar (REACT):online, observer-blind, randomised controlled superiority trial

Lobban, Fiona and Akers, Nadia and Appelbe, Duncan and Chapman, Lesley and Collinge, Lizzi and Dodd, Susanna and Flowers, Sue and Hollingsworth, Bruce and Johnson, Sonia and Jones, Steven H and Mateus, Ceu and Mezes, Barbara and Murray, Elizabeth and Panagaki, Katerina and Rainford, Naomi and Robinson, Heather and Rosala-Hallas, Anna and Sellwood, William and Walker, Andrew and Williamson, Paula (2020) Clinical effectiveness of a web-based peer-supported self-management intervention for relatives of people with psychosis or bipolar (REACT):online, observer-blind, randomised controlled superiority trial. BMC Psychiatry, 20 (1). ISSN 1471-244X

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Abstract

Background The Relatives Education And Coping Toolkit (REACT) is an online supported self-management toolkit for relatives of people with psychosis or bipolar designed to improve access to NICE recommended information and emotional support. Aims Our aim was to determine clinical and cost-effectiveness of REACT including a Resource Directory (RD), versus RD-only. Methods A primarily online, observer-blind randomised controlled trial comparing REACT (including RD) with RD only (registration ). Participants were UK relatives aged > = 16, with high distress (assessed using the GHQ-28), and actively help-seeking, individually randomised, and assessed online. Primary outcome was relatives' distress (GHQ-28) at 24 weeks. Secondary outcomes were wellbeing, support, costs and user feedback. Results We recruited 800 relatives (REACT = 399; RD only = 401) with high distress at baseline (GHQ-28 REACT mean 40.3, SD 14.6; RD only mean 40.0, SD 14.0). Median time spent online on REACT was 50.8 min (IQR 12.4-172.1) versus 0.5 min (IQR 0-1.6) on RD only. Retention to primary follow-up (24 weeks) was 75% (REACT n = 292 (73.2%); RD-only n = 307 (76.6%)). Distress decreased in both groups by 24 weeks, with no significant difference between the two groups (- 1.39, 95% CI -3.60, 0.83, p = 0.22). Estimated cost of delivering REACT was 62.27 pound per person and users reported finding it safe, acceptable and convenient. There were no adverse events or reported side effects. Conclusions REACT is an inexpensive, acceptable, and safe way to deliver NICE-recommended support for relatives. However, for highly distressed relatives it is no more effective in reducing distress (GHQ-28) than a comprehensive online resource directory.

Item Type:
Journal Article
Journal or Publication Title:
BMC Psychiatry
Uncontrolled Keywords:
/dk/atira/pure/subjectarea/asjc/2700/2738
Subjects:
ID Code:
143524
Deposited By:
Deposited On:
24 Apr 2020 11:20
Refereed?:
Yes
Published?:
Published
Last Modified:
23 Sep 2020 06:06