What works for whom in a computer-mediated communication intervention in community psychiatry? Moderators of outcome in a cluster randomized trial

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Abstract:

Hansson L, Svensson B, Björkman T, Bullenkamp J, Lauber C, Martinez-Leal R, McCabe R, Rössler W, Salize H, Torres-Gonzales F, van den Brink R, Wiersma D, Priebe S. What works for whom in a computer-mediated communication intervention in community psychiatry? Moderators of outcome in a cluster randomized trial. Objective: 

An intervention to structure patient–key worker communication has been tested in a randomized controlled trial. The aim of this paper was to investigate effectiveness of the intervention in terms of moderators of effectiveness. Method: 

A total of 507 patients with schizophrenia were included. Moderators of effectiveness were investigated using two-wayanovas. Results: 

Patients with a better relationship with their key worker and a shorter duration of illness at baseline benefited more from the intervention in terms of quality of life. Patients who received the intervention who were in competitive employment or had a shorter duration of illness showed greater reduction of unmet needs. Older patients receiving the intervention had better treatment satisfaction. Conclusion: 

Outcome of the intervention was moderated by patient characteristics. Moreover, the moderating characteristics varied depending on the specific outcome. Evidence on moderators is very limited, even though, they are significant for understanding, targeting and implementing complex interventions.

Keywords: quality of life; randomized controlled trial; rehabilitation; schizophrenia; social psychiatry

Document Type: Research Article

DOI: http://dx.doi.org/10.1111/j.1600-0447.2008.01258.x

Affiliations: 1: Department of Health Sciences, Lund University, Lund, Sweden 2: Central Institute for Mental Health, Mannheim, Germany 3: Department for Social and Clinical Psychiatry, Psychiatric University Hospital, Zurich, Switzerland 4: Department of Psychiatry, University of Granada, Granada, Spain 5: The Unit for Social and Community Psychiatry, Queen Mary University of London, London, UK 6: Department of Psychiatry, University of Groningen, Groningen, the Netherlands

Publication date: November 1, 2008

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