Collaborative community based care for people and their families living with schizophrenia in India: protocol for a randomised controlled trial


Chatterjee, S; Leese, M; Koschorke, M; McCrone, P; Naik, S; John, S; Dabholkar, H; Goldsmith, K; Balaji, M; Varghese, M; Thara, R; Patel, V; Thornicroft, G; (2011) Collaborative community based care for people and their families living with schizophrenia in India: protocol for a randomised controlled trial. Trials, 12. ISSN 1745-6215 DOI: https://doi.org/10.1186/1745-6215-12-12

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Abstract

Background: There is a large treatment gap with few community services for people with schizophrenia in low income countries largely due to the shortage of specialist mental healthcare human resources. Community based rehabilitation (CBR), involving lay health workers, has been shown to be feasible, acceptable and more effective than routine care for people with schizophrenia in observational studies. The aim of this study is to evaluate whether a lay health worker led, Collaborative Community Based Care (CCBC) intervention, combined with usual Facility Based Care (FBC), is superior to FBC alone in improving outcomes for people with schizophrenia and their caregivers in India. Methods/Design: This trial is a multi-site, parallel group randomised controlled trial design in India. The trial will be conducted concurrently at three sites in India where persons with schizophrenia will be screened for eligibility and recruited after providing informed consent. Trial participants will be randomly allocated in a 2: 1 ratio to the CCBC+FBC and FBC arms respectively using an allocation sequence pre-prepared through the use of permuted blocks, stratified within site. The structured CCBC intervention will be delivered by trained lay community health workers (CHWs) working together with the treating Psychiatrist. We aim to recruit 282 persons with schizophrenia. The primary outcomes are reduction in severity of symptoms of schizophrenia and disability at 12 months. The study will be conducted according to good ethical practice, data analysis and reporting guidelines. Discussion: If the additional CCBC intervention delivered by front line CHWs is demonstrated to be effective and cost-effective in comparison to usually available care, this intervention can be scaled up to expand coverage and improve outcomes for persons with schizophrenia and their caregivers in low income countries.

Item Type: Article
Keywords: RURAL INDIA, HEALTH, COUNTRIES, DESIGN, SCALE
Faculty and Department: Faculty of Epidemiology and Population Health > Dept of Population Health (2012- ) > Dept of Nutrition and Public Health Interventions Research (2003-2012)
Faculty of Epidemiology and Population Health > Dept of Population Health (2012- )
Research Centre: Centre for Global Mental Health
Centre for Global Non-Communicable Diseases (NCDs)
PubMed ID: 21226970
Web of Science ID: 287157900001
URI: http://researchonline.lshtm.ac.uk/id/eprint/1223

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