medwireNews: Findings from a recent real-world clinical study indicate that relatives of people with recent-onset psychosis benefit from supported self-management interventions to help with outcomes such as distress and negative feelings around caregiving.
The Relatives’ Education And Coping Toolkit (REACT) study evaluated the effectiveness, acceptability, and feasibility of this type of intervention, using five outcome measures, in 103 partners, relatives, and close friends of people being treated for new-onset psychosis. Participants were randomized to receive treatment as usual (TAU), a support-program policy outlined by the UK National Health Service, or TAU plus the REACT intervention (supported by a trained services worker).
Writing in TheBritish Journal of Psychiatry, Fiona Lobban (Lancaster University, UK) and colleagues report that, at 6 months of follow-up, those who received the REACT intervention had “greater reduction in distress, negative experiences of caregiving, and concern about psychosis, along with increased positive experiences of caregiving, carer well-being and support, and perceived ability to cope.”
However, the only significant differences between the two groups were in terms of distress reduction and increases in perceived coping and sense of support.
Those in the TAU group rated their satisfaction with the program and the amount of support they received. While 64% were mostly or very satisfied overall, ratings were low for practical support (eg, with finances) and stress management advice.
Lobban and colleagues note that overall support varied considerably among the participants. However, “[t]his study is too small to examine quantitatively the role of the support and whether there is a minimum amount of support required for the toolkit to be effective. Indeed, it is possible that the support rather than the toolkit is the essential component.”
As well, the cost-effectiveness of REACT was not evaluated. However, it is intended to be a low-intensity program.
REACT has 13 modules designed to be used flexibly to suit the needs of the relative or caregiver. The modules are relatively short, and include case studies and links to outside resources. Future iterations of REACT could include peer support, specific elements geared towards minority populations, and more online tools, the researchers suggest.
They also recommend that a larger trial be conducted “to reliably assess the clinical and cost-effectiveness of the REACT intervention. This study should focus on long- as well as short-term outcomes and further attempt to identify the contribution of the toolkit and support in determining outcome.”
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