Onset of First Episode Psychosis (FEP) is at a young age and is a critical period
influencing the long-term course of the disorder. Failure to identify FEP can lead to
serious implications such as disruption of education, reduced long-term employment, huge
economic burden, and is associated with significantly higher mortality. The prevalence of
psychosis increases rapidly from age 14 onwards with a peak incidence in the late teens
and early 20s. The aim of the project is to examine the acceptability and feasibility of
a mobile phone application-based intervention 'TechCare-PK', for individuals with
psychosis in Pakistan. The main objectives are to determine whether appropriate
individuals could be identified and recruited to the study and whether the TechCare App
would be an acceptable intervention for individuals with psychosis.
Where there are challenges related to distance, inconvenience, being homebound or
reluctance to face-to-face interventions, Mobile Health (mHealth) approaches that
leverage mobile devices such as cellular phones and smartphones can be used to support
healthcare system. Research has found mobile based interventions as highly acceptable to
families and may meet carers' needs in respect of information, guidance, professional and
emotional support. These services has been considered as a good and easy mode of
exchanging information, providing health related education and advice, management of
symptoms, to early recognize the complications, giving reassurance and for providing
quality services.
Methods:
Study Design: A multi-center single blind Randomised Controlled Trial (RCT) comparing
with Treatment as Usual (TAU) with participants with First Episode Psychosis (FEP) to be
recruited from different psychiatric units across four cities in Pakistan i.e., Karachi,
Lahore, Hyderabad and Rawalpindi, Pakistan. If required additional centers will be added
i.e., Quetta, Multan and Peshawar following proper ethics amendments.
Aim The aim of this study is to design, and test culturally adapted mobile based CBT
intervention for patients with FEP.
Objectives:
Develop and refine an app based intervention (TechCare) based on existing culturally
adapted intervention for psychosis, using patient and public involvement. The aim is
to improve its potential efficacy, establish acceptability of the refined
intervention to potential participants and facilitators and establish mobile app
based deliverability of the intervention
To explore the usefulness of TechCare as an acceptable intervention in reducing
symptoms of psychosis.
Undertake an internal pilot to establish recruitment and attrition rates, compliance
with protocol and acceptability of the trial design to participants.
The proposed study will consist of three phases. First phase of study will focus on
developing the app based intervention (TechCare) through qualitative work. Second phase
will test run the application with 6-8 service users and incorporate suggestions and
refinement of intervention and in the third phase we will test it in a randomised
controlled trial.