Cargando…

Effect of digital psychoeducation and peer support on the mental health of family carers supporting individuals with psychosis in England (COPe-support): a randomised clinical trial

BACKGROUND: Psychoeducation delivered face-to-face is effective in alleviating mental health morbidities in family carers of individuals with psychosis. However, research in such interventions delivered online is scarce. We evaluated the effectiveness of a digital multicomponent intervention—COPe-su...

Descripción completa

Detalles Bibliográficos
Autores principales: Sin, Jacqueline, Henderson, Claire, Elkes, Jack, Cornelius, Victoria, Woodham, Luke A, Batchelor, Rachel, Chen, Tao, Corredor, Ana Maria, Coughlan, David, Dhital, Ranjita, Evans, Sian, Haider, Ban, Heathcote, Julia, Mansfield, Sarah, O'Brien, Aileen, Qassim, Mona, Sserunkuma, Juliet, Travis, Clive H, Williams, Elen, Gillard, Steve
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier Ltd 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9021027/
https://www.ncbi.nlm.nih.gov/pubmed/35379593
http://dx.doi.org/10.1016/S2589-7500(22)00031-0
_version_ 1784689707912790016
author Sin, Jacqueline
Henderson, Claire
Elkes, Jack
Cornelius, Victoria
Woodham, Luke A
Batchelor, Rachel
Chen, Tao
Corredor, Ana Maria
Coughlan, David
Dhital, Ranjita
Evans, Sian
Haider, Ban
Heathcote, Julia
Mansfield, Sarah
O'Brien, Aileen
Qassim, Mona
Sserunkuma, Juliet
Travis, Clive H
Williams, Elen
Gillard, Steve
author_facet Sin, Jacqueline
Henderson, Claire
Elkes, Jack
Cornelius, Victoria
Woodham, Luke A
Batchelor, Rachel
Chen, Tao
Corredor, Ana Maria
Coughlan, David
Dhital, Ranjita
Evans, Sian
Haider, Ban
Heathcote, Julia
Mansfield, Sarah
O'Brien, Aileen
Qassim, Mona
Sserunkuma, Juliet
Travis, Clive H
Williams, Elen
Gillard, Steve
author_sort Sin, Jacqueline
collection PubMed
description BACKGROUND: Psychoeducation delivered face-to-face is effective in alleviating mental health morbidities in family carers of individuals with psychosis. However, research in such interventions delivered online is scarce. We evaluated the effectiveness of a digital multicomponent intervention—COPe-support—in improving carers' mental wellbeing and caregiving-related outcomes. METHODS: In this two-arm, individually randomised, superiority trial, people aged 18 years or older who provided at least weekly support in any format for a relative or close friend affected by psychosis across England were randomly assigned (1:1) to either COPe-support or a passive online information resource using an independent online system. Participants were recruited through 30 mental health UK National Health Service trusts. The study team were masked to allocation and assessment of outcomes as all data collection took place online. Participants had access to either condition for 40 weeks and were advised to spend at least half an hour per week over the initial 20 weeks to go through materials at their own pace and to allow time to integrate knowledge and skills learned into practice. It was not feasible to mask participants or the online facilitator to intervention allocation. COPe-support provided psychoeducation on psychosis-related caregiving strategies and forums with professionals and other carers, and the control intervention comprised a passive online information resource. The primary outcome at 20 weeks was mental wellbeing measured by the Warwick-Edinburgh Mental Wellbeing Scale (WEMWBS; minimally clinically important difference [MCID] 3). This trial is registered with ISRCTN, 89563420. FINDINGS: Between March 1, 2018, and Feb 14, 2020, 407 participants were randomly assigned, with 204 allocated to COPe-support and 203 allocated to control. The participants (mean age 53·1 years, SD 13·2) were mostly female (330 [81%] of 407 participants) and White (359 [88%] of 407 participants). 346 (85%) of 407 participants provided primary endpoint data, 174 (85%) of 204 participants in the COPe-support group and 172 (85%) of 203 participants in the control group. The mean WEMWBS score at 20 weeks was 44·5 (SD 8·31) for the COPe-support group and 43·3 (9·19) for the control group. We found no evidence of a difference in wellbeing between the two groups (adjusted mean difference 0·37, 95% CI –1·14 to 1·88; p=0·63). In the COPe-support group, 106 (52%) of 204 participants met the complier definition of a minimum of two logins in separate weeks. The complier average causal effect analysis increased the difference in WEMWBS scores (adjusted difference 0·83, 95% CI –1·45 to 3·11; p=0·47), but this was lower than the MCID. There were no adverse events. INTERPRETATION: Our findings did not support the use of COPe-support over a passive online information resource. However, further research to optimise digital interventions adjunctive to face-to-face support for carers remains important. FUNDING: National Institute for Health Research.
format Online
Article
Text
id pubmed-9021027
institution National Center for Biotechnology Information
language English
publishDate 2022
publisher Elsevier Ltd
record_format MEDLINE/PubMed
spelling pubmed-90210272022-05-24 Effect of digital psychoeducation and peer support on the mental health of family carers supporting individuals with psychosis in England (COPe-support): a randomised clinical trial Sin, Jacqueline Henderson, Claire Elkes, Jack Cornelius, Victoria Woodham, Luke A Batchelor, Rachel Chen, Tao Corredor, Ana Maria Coughlan, David Dhital, Ranjita Evans, Sian Haider, Ban Heathcote, Julia Mansfield, Sarah O'Brien, Aileen Qassim, Mona Sserunkuma, Juliet Travis, Clive H Williams, Elen Gillard, Steve Lancet Digit Health Articles BACKGROUND: Psychoeducation delivered face-to-face is effective in alleviating mental health morbidities in family carers of individuals with psychosis. However, research in such interventions delivered online is scarce. We evaluated the effectiveness of a digital multicomponent intervention—COPe-support—in improving carers' mental wellbeing and caregiving-related outcomes. METHODS: In this two-arm, individually randomised, superiority trial, people aged 18 years or older who provided at least weekly support in any format for a relative or close friend affected by psychosis across England were randomly assigned (1:1) to either COPe-support or a passive online information resource using an independent online system. Participants were recruited through 30 mental health UK National Health Service trusts. The study team were masked to allocation and assessment of outcomes as all data collection took place online. Participants had access to either condition for 40 weeks and were advised to spend at least half an hour per week over the initial 20 weeks to go through materials at their own pace and to allow time to integrate knowledge and skills learned into practice. It was not feasible to mask participants or the online facilitator to intervention allocation. COPe-support provided psychoeducation on psychosis-related caregiving strategies and forums with professionals and other carers, and the control intervention comprised a passive online information resource. The primary outcome at 20 weeks was mental wellbeing measured by the Warwick-Edinburgh Mental Wellbeing Scale (WEMWBS; minimally clinically important difference [MCID] 3). This trial is registered with ISRCTN, 89563420. FINDINGS: Between March 1, 2018, and Feb 14, 2020, 407 participants were randomly assigned, with 204 allocated to COPe-support and 203 allocated to control. The participants (mean age 53·1 years, SD 13·2) were mostly female (330 [81%] of 407 participants) and White (359 [88%] of 407 participants). 346 (85%) of 407 participants provided primary endpoint data, 174 (85%) of 204 participants in the COPe-support group and 172 (85%) of 203 participants in the control group. The mean WEMWBS score at 20 weeks was 44·5 (SD 8·31) for the COPe-support group and 43·3 (9·19) for the control group. We found no evidence of a difference in wellbeing between the two groups (adjusted mean difference 0·37, 95% CI –1·14 to 1·88; p=0·63). In the COPe-support group, 106 (52%) of 204 participants met the complier definition of a minimum of two logins in separate weeks. The complier average causal effect analysis increased the difference in WEMWBS scores (adjusted difference 0·83, 95% CI –1·45 to 3·11; p=0·47), but this was lower than the MCID. There were no adverse events. INTERPRETATION: Our findings did not support the use of COPe-support over a passive online information resource. However, further research to optimise digital interventions adjunctive to face-to-face support for carers remains important. FUNDING: National Institute for Health Research. Elsevier Ltd 2022-04-01 /pmc/articles/PMC9021027/ /pubmed/35379593 http://dx.doi.org/10.1016/S2589-7500(22)00031-0 Text en © 2022 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license https://creativecommons.org/licenses/by/4.0/This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Articles
Sin, Jacqueline
Henderson, Claire
Elkes, Jack
Cornelius, Victoria
Woodham, Luke A
Batchelor, Rachel
Chen, Tao
Corredor, Ana Maria
Coughlan, David
Dhital, Ranjita
Evans, Sian
Haider, Ban
Heathcote, Julia
Mansfield, Sarah
O'Brien, Aileen
Qassim, Mona
Sserunkuma, Juliet
Travis, Clive H
Williams, Elen
Gillard, Steve
Effect of digital psychoeducation and peer support on the mental health of family carers supporting individuals with psychosis in England (COPe-support): a randomised clinical trial
title Effect of digital psychoeducation and peer support on the mental health of family carers supporting individuals with psychosis in England (COPe-support): a randomised clinical trial
title_full Effect of digital psychoeducation and peer support on the mental health of family carers supporting individuals with psychosis in England (COPe-support): a randomised clinical trial
title_fullStr Effect of digital psychoeducation and peer support on the mental health of family carers supporting individuals with psychosis in England (COPe-support): a randomised clinical trial
title_full_unstemmed Effect of digital psychoeducation and peer support on the mental health of family carers supporting individuals with psychosis in England (COPe-support): a randomised clinical trial
title_short Effect of digital psychoeducation and peer support on the mental health of family carers supporting individuals with psychosis in England (COPe-support): a randomised clinical trial
title_sort effect of digital psychoeducation and peer support on the mental health of family carers supporting individuals with psychosis in england (cope-support): a randomised clinical trial
topic Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9021027/
https://www.ncbi.nlm.nih.gov/pubmed/35379593
http://dx.doi.org/10.1016/S2589-7500(22)00031-0
work_keys_str_mv AT sinjacqueline effectofdigitalpsychoeducationandpeersupportonthementalhealthoffamilycarerssupportingindividualswithpsychosisinenglandcopesupportarandomisedclinicaltrial
AT hendersonclaire effectofdigitalpsychoeducationandpeersupportonthementalhealthoffamilycarerssupportingindividualswithpsychosisinenglandcopesupportarandomisedclinicaltrial
AT elkesjack effectofdigitalpsychoeducationandpeersupportonthementalhealthoffamilycarerssupportingindividualswithpsychosisinenglandcopesupportarandomisedclinicaltrial
AT corneliusvictoria effectofdigitalpsychoeducationandpeersupportonthementalhealthoffamilycarerssupportingindividualswithpsychosisinenglandcopesupportarandomisedclinicaltrial
AT woodhamlukea effectofdigitalpsychoeducationandpeersupportonthementalhealthoffamilycarerssupportingindividualswithpsychosisinenglandcopesupportarandomisedclinicaltrial
AT batchelorrachel effectofdigitalpsychoeducationandpeersupportonthementalhealthoffamilycarerssupportingindividualswithpsychosisinenglandcopesupportarandomisedclinicaltrial
AT chentao effectofdigitalpsychoeducationandpeersupportonthementalhealthoffamilycarerssupportingindividualswithpsychosisinenglandcopesupportarandomisedclinicaltrial
AT corredoranamaria effectofdigitalpsychoeducationandpeersupportonthementalhealthoffamilycarerssupportingindividualswithpsychosisinenglandcopesupportarandomisedclinicaltrial
AT coughlandavid effectofdigitalpsychoeducationandpeersupportonthementalhealthoffamilycarerssupportingindividualswithpsychosisinenglandcopesupportarandomisedclinicaltrial
AT dhitalranjita effectofdigitalpsychoeducationandpeersupportonthementalhealthoffamilycarerssupportingindividualswithpsychosisinenglandcopesupportarandomisedclinicaltrial
AT evanssian effectofdigitalpsychoeducationandpeersupportonthementalhealthoffamilycarerssupportingindividualswithpsychosisinenglandcopesupportarandomisedclinicaltrial
AT haiderban effectofdigitalpsychoeducationandpeersupportonthementalhealthoffamilycarerssupportingindividualswithpsychosisinenglandcopesupportarandomisedclinicaltrial
AT heathcotejulia effectofdigitalpsychoeducationandpeersupportonthementalhealthoffamilycarerssupportingindividualswithpsychosisinenglandcopesupportarandomisedclinicaltrial
AT mansfieldsarah effectofdigitalpsychoeducationandpeersupportonthementalhealthoffamilycarerssupportingindividualswithpsychosisinenglandcopesupportarandomisedclinicaltrial
AT obrienaileen effectofdigitalpsychoeducationandpeersupportonthementalhealthoffamilycarerssupportingindividualswithpsychosisinenglandcopesupportarandomisedclinicaltrial
AT qassimmona effectofdigitalpsychoeducationandpeersupportonthementalhealthoffamilycarerssupportingindividualswithpsychosisinenglandcopesupportarandomisedclinicaltrial
AT sserunkumajuliet effectofdigitalpsychoeducationandpeersupportonthementalhealthoffamilycarerssupportingindividualswithpsychosisinenglandcopesupportarandomisedclinicaltrial
AT traviscliveh effectofdigitalpsychoeducationandpeersupportonthementalhealthoffamilycarerssupportingindividualswithpsychosisinenglandcopesupportarandomisedclinicaltrial
AT williamselen effectofdigitalpsychoeducationandpeersupportonthementalhealthoffamilycarerssupportingindividualswithpsychosisinenglandcopesupportarandomisedclinicaltrial
AT gillardsteve effectofdigitalpsychoeducationandpeersupportonthementalhealthoffamilycarerssupportingindividualswithpsychosisinenglandcopesupportarandomisedclinicaltrial