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

Anne Fiona Lobban, Nadia Akers, Duncan Appelbe, Lesley Chapman, Elizabeth Collinge, Susanna Dodd, Sue Flowers, Bruce Hollingsworth, Sonia Johnson, Steven Huntley Jones, Ceu Mateus, Barbara Mezes, Elizabeth Murray, Katerina Panagaki, Naomi Rainford, Heather Amy Robinson, Anna Rosala-Hallas, William Sellwood, Andrew Walker, Paula Williamson

Research output: Contribution to journalArticle

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 ISRCTN72019945). 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 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. Trial registration: ISRCTN72019945 prospectively registered 19/11/2015.

Original languageEnglish
Article number160
JournalBMC Psychiatry
Volume20
Issue number1
DOIs
Publication statusPublished - 14 Apr 2020

Bibliographical note

This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

Keywords

  • Bipolar
  • Digital health intervention
  • Psychosis
  • Randomised controlled trial
  • Relatives

Fingerprint Dive into the research topics of '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'. Together they form a unique fingerprint.

  • Cite this

    Lobban, A. F., Akers, N., Appelbe, D., Chapman, L., Collinge, E., Dodd, S., Flowers, S., Hollingsworth, B., Johnson, S., Jones, S. H., Mateus, C., Mezes, B., Murray, E., Panagaki, K., Rainford, N., Robinson, H. A., Rosala-Hallas, A., Sellwood, W., Walker, A., & Williamson, P. (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), [160]. https://doi.org/10.1186/s12888-020-02545-9