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  • Lay health supporters aided by a mobile phone messaging system to improve care of villagers with schizophrenia in Liuyang, China: protocol for a randomised control trial

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Mental health
Protocol
Lay health supporters aided by a mobile phone messaging system to improve care of villagers with schizophrenia in Liuyang, China: protocol for a randomised control trial
  1. Dong (Roman) Xu1,2,
  2. Wenjie Gong3,4,
  3. Eric D Caine4,
  4. Shuiyuan Xiao3,
  5. James P Hughes5,
  6. Marie Ng6,
  7. Jane Simoni7,
  8. Hua He8,
  9. Kirk L Smith9,
  10. Henry Shelton Brown III10,
  11. Stephen Gloyd2
  1. 1Sun Yat-sen Global Health Institute (SGHI), School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, China
  2. 2Department of Global Health, University of Washington, Seattle, Washington, USA
  3. 3Xiangya School of Public Health, Central South University, Changsha, Hunan, China
  4. 4Department of Psychiatry, University of Rochester Medical Center, Rochester, New York, USA
  5. 5Department of Biostatistics, University of Washington, Seattle, Washington, USA
  6. 6Institute for Health Metrics and Evaluation, University of Washington, Seattle, Washington, USA
  7. 7Department of Phycology, University of Washington, Seattle, Washington, USA
  8. 8Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, Louisiana, USA
  9. 9Division of Health Promotion and Behavioral Sciences, University of Texas Health Science Center School of Public Health at Houston, Houston, Texas, USA
  10. 10Austin Regional Campus Michael & Susan Dell Center for Healthy Living, UTHealth School of Public Health, Austin, Texas, USA
  1. Correspondence to Dr Wenjie Gong; gongwenjie{at}csu.edu.cn

Abstract

Introduction Schizophrenia is a severe, chronic and disabling mental illness. Non-adherence to medication and relapse may lead to poorer patient function. This randomised controlled study, under the acronym LEAN (Lay health supporter, e-platform, award, and iNtegration), is designed to improve medication adherence and high relapse among people with schizophrenia in resource poor settings.

Methods/analysis The community-based LEAN has four parts: (1) Lay health supporters (LHSs), mostly family members who will help supervise patient medication, monitor relapse and side effects, and facilitate access to care, (2) an E-platform to support two-way mobile text and voice messaging to remind patients to take medication; and alert LHSs when patients are non-adherent, (3) an Award system to motivate patients and strengthen LHS support, and (4) iNtegration of the efforts of patients and LHSs with those of village doctors, township mental health administrators and psychiatrists via the e-platform. A random sample of 258 villagers with schizophrenia will be drawn from the schizophrenic ‘686’ Program registry for the 9 Xiang dialect towns of the Liuyang municipality in China. The sample will be further randomised into a control group and a treatment group of equal sizes, and each group will be followed for 6 months after launch of the intervention. The primary outcome will be medication adherence as measured by pill counts and supplemented by pharmacy records. Other outcomes include symptoms and level of function. Outcomes will be assessed primarily when patients present for medication refill visits scheduled every 2 months over the 6-month follow-up period. Data from the study will be analysed using analysis of covariance for the programme effect and an intent-to-treat approach.

Ethics and dissemination University of Washington: 49464 G; Central South University: CTXY-150002-6. Results will be published in peer-reviewed journals with deidentified data made available on FigShare.

Trial registration number ChiCTR-ICR-15006053; Pre-results.

  • schizophrenia
  • medication adherence
  • mHealth
  • lay health worker
  • implementation science
  • “686” program

This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/

https://doi.org/10.1136/bmjopen-2015-010120

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