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Evaluation of the impact of a PsychoEducational intervention on knowledge levels and Psychological outcomes for schizophrenic patients and their carers in Jordan
ISRCTN ISRCTN78084871
DOI 10.1186/ISRCTN78084871
ClinicalTrials.gov identifier
EudraCT number
Public title Evaluation of the impact of a PsychoEducational intervention on knowledge levels and Psychological outcomes for schizophrenic patients and their carers in Jordan
Scientific title Evaluation of the impact of a PsychoEducational intervention on knowledge levels and Psychological outcomes for people diagnosed with schizophrenia and their carers in Jordan: A randomized controlled trial and process evaluation
Acronym PEP
Serial number at source N/A
Study hypothesis Patients who receive psychoeducation will show equal or greater knowledge of schizophrenia, improved psychotic symptoms and lower relapse rates at post-intervention and follow-up than patients who receive treatment as usual (TAU).

Carers who receive psychoeducation will show equal or greater knowledge of schizophrenia, lower burden of care and improved quality of life post-intervention and follow-up than carers who receive TAU.
Lay summary Background and study aims
Schizophrenia is one of the most serious forms of mental illness among people being treated in psychiatric clinics in developing and developed countries, and can be chronic , recurrent, disabling and debilitating (affecting the ability to carry on with regular activities). The aims of this study are to examine the effectiveness of delivering a psychoeducational intervention, in booklet form, on schizophrenia knowledge of patients and caregivers, positive and negative schizophrenia symptoms, relapse rate of patients, burden of care, and quality of life of caregivers.

Who can participate?
The study aims to recruit about 144 men and women living with schizophrenia or schizoaffective disorder and their primary caregivers, age > 18 years from outpatient clinics in four mental health clinics in Jordan.

What does the study involve?
At baseline (before the start of the intervention), participants were invited to sign a consent form and complete baseline measures (knowledge level, schizophrenia symptoms and relapse rate). Baseline measures for carers are knowledge level, burden of care and quality of life. Participants were randomly allocated to one of two groups: participants in the intervention arm of the study received a psychoeducation booklet each fortnight plus treatment as usual in the clinic for 12 weeks. On the other hand, participants in control group received treatment as usual in the outpatient clinic for 12 weeks. The outcomes were again measured at the end of the treatment and at three months follow-up.

What are the possible benefits and risks of participating?
Potential benefits from this study include increasing patientsí knowledge about schizophrenia, improved positive and negative symptoms associated with schizophrenia and reduced relapse rate. Potential benefits to caregivers are improved quality of life, enhanced knowledge level and reduced burden of care.

Where is the study run from?
In the four major outpatient clinics for mental health in Jordan.

When is the study starting and how long is it expected to run for?
Recruitment started at the end of 2012. Participants were enrolled on the study for a period of 6 months.

Who is funding the study?
Islamic Development Bank (Saudi Arabia).

Who is the main contact?
Professor Patrick Callaghan
Dr Joanne Lymn, Joanne.Lymn@nottingham.ac.uk
Mr Abd Alhadi Hasan, ntxah3@nottinghama.ac.uk
Ethics approval 1. Jordanian Ministry of Health Ethics Committee, 10/08/2012
2. University of Nottingham Medical Ethical Committee, 23/07/2012
Study design Placebo-controlled single-blind randomized controlled clinical trial
Countries of recruitment Jordan
Disease/condition/study domain Schizophrenia
Participants - inclusion criteria Patients:
1. Diagnosed with schizophrenia or schizoaffective disorder based on the Diagnostic and Statistical Manual of Mental Disorders, 4th Edition (DSM-IV)
2. Able to read Arabic or English language
3. Written consent
5. Aged 18 or over, either sex

Caregivers:
1. Primary caregivers - caregivers who mostly involved in patientsí care
2. Able to read Arabic or English language
3. Written consent
5. Aged 18 or over, either sex
Participants - exclusion criteria Patients:
1. Any learning disability
2. Presence of known organic mental disorder
3. Had a history of substance abuse or current substance abuse
4. Living alone without caregivers or attended any psychosocial intervention previously

Caregivers:
Involved in caring for more than one patient with mental disorder
Anticipated start date 01/09/2012
Anticipated end date 01/05/2013
Status of trial Completed
Patient information material Not available in web format, please use the contact details below to request a patient information sheet
Target number of participants 144
Interventions Intervention: treatment as usual + psychoeducational intervention
Based on Atkinson and Coia model. It consists of six booklets each fortnight covering essential topics to patients and carers:
1. General information about schizophrenia
2. Anti-psychotic medication effects and side effects
3. Relapse signs
4. Problem solving
5. Coping with Illness

Control:
Treatment as usual for 12 weeks.

Patients and carers will be followed up at baseline, end of treatment and three months follow-up.
Primary outcome measure(s) 1. Patients' primary outcome is knowledge level about schizophrenia measured by knowledge about schizophrenia questionnaires (KASQ)
2. Carers' primary outcome is knowledge level about schizophrenia measured by knowledge about schizophrenia questionnaires (KASQ)

All outcomes measured at baseline, end of treatment and three months follow up.
Secondary outcome measure(s) Patient:
1. Schizophrenia symptoms are measured by the positive and negative syndrome scale (PANSS)
2. Relapse with hospitalization is measured by the number of mental hospital re-admissions
3. Relapse with medication is calculated by the number of anti-psychotic drug dosage increases

Caregivers:
1. Burden of care is measured by Family Burden Interview Schedule (FBIS)
2. Quality of life is measured by Schizophrenia-Caregiver Quality of Life (S-CQoL)

All outcomes measured at baseline, end of treatment and three months follow up.
Sources of funding Islamic Development Bank (Saudi Arabia)
Trial website
Publications 2014 protocol in: http://www.ncbi.nlm.nih.gov/pubmed/24450608
Contact name Dr  Patrick  Callaghan
  Address University of Nottingham
A Floor
Queens Medical Centre
  City/town Nottingham
  Zip/Postcode NG7 2HA
  Country United Kingdom
Sponsor University of Nottingham (UK)
  Address Queens Medical Centre
  City/town Nottingham
  Zip/Postcode NG7 2HA
  Country United Kingdom
  Sponsor website: http://www.nottingham.ac.uk/
Date applied 27/11/2013
Last edited 27/01/2014
Date ISRCTN assigned 16/12/2013
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