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BMC Psychiatry
Published in: BMC Psychiatry 1/2017

Open Access 01-12-2017 | Research article

Randomised control trial of the effectiveness of an integrated psychosocial health promotion intervention aimed at improving health and reducing substance use in established psychosis (IMPaCT)

Authors: Fiona Gaughran, Daniel Stahl, Khalida Ismail, Kathryn Greenwood, Zerrin Atakan, Poonam Gardner-Sood, Brendon Stubbs, David Hopkins, Anita Patel, John Lally, Philippa Lowe, Maurice Arbuthnot, Diana Orr, Sarah Corlett, Jonas Eberhard, Anthony S. David, Robin Murray, Shubulade Smith, on behalf of the IMPaCT Team

Published in: BMC Psychiatry | Issue 1/2017

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Abstract

Background

People with psychosis have a reduced life expectancy of 10–20 years, largely due to cardiovascular disease. This trial aimed to determine the effectiveness of a modular health promotion intervention (IMPaCT Therapy) in improving health and reducing cardiovascular risk in psychosis.

Methods

A multicentre, two arm, parallel cluster RCT was conducted across five UK mental health NHS trusts. Community care coordinators (CC) were randomly assigned to training and supervision in delivering IMPaCT Therapy or treatment as usual (TAU) to current patients with psychosis (cluster). The primary outcome was the physical and mental health subscales of the Short form-36 (SF-36) questionnaire.

Results

Of 104 care coordinators recruited, 52 (with 213 patients) were randomised to deliver IMPaCT therapy and 52 (with 193 patients) randomised to TAU. Of 406 patients, 318 (78%) and 301 (74%) attended 12- and 15-month follow-up respectively. IMPaCT therapy showed no significant effect on the physical or mental health component SF-36 scores versus TAU at 12 or 15 months. No effect was observed for cardiovascular risk indicators, except for HDL cholesterol, which improved more with IMPACT therapy than TAU (Treatment effect (95% CI); 0.085 (0.007 to 0.16); p = 0.034). The 22% of patients who received >180 min of IMPACT Therapy in addition to usual care achieved a greater reduction in waist circumference than did controls, which was clinically significant.

Conclusion

Training and supervising community care coordinators to use IMPaCT therapy in patients with psychosis is insufficient to significantly improve physical or mental health quality of life. The search for effective, pragmatic interventions deliverable in health care services continues.

Trial registration

The trial was retrospectively registered with ISRCTN registry on 23/4/2010 at ISRCTN58667926; recruitment started on 01/03/2010 with first randomization on 09.08.2010 ISRCTN58667926.
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Metadata
Title
Randomised control trial of the effectiveness of an integrated psychosocial health promotion intervention aimed at improving health and reducing substance use in established psychosis (IMPaCT)
Authors
Fiona Gaughran
Daniel Stahl
Khalida Ismail
Kathryn Greenwood
Zerrin Atakan
Poonam Gardner-Sood
Brendon Stubbs
David Hopkins
Anita Patel
John Lally
Philippa Lowe
Maurice Arbuthnot
Diana Orr
Sarah Corlett
Jonas Eberhard
Anthony S. David
Robin Murray
Shubulade Smith
on behalf of the IMPaCT Team
Publication date
01-12-2017
Publisher
BioMed Central
Published in
BMC Psychiatry / Issue 1/2017
Electronic ISSN: 1471-244X
DOI
https://doi.org/10.1186/s12888-017-1571-0

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