An online randomised controlled trial to evaluate the clinical and cost effectiveness of a peer supported self-management intervention for relatives of people with psychosis or bipolar disorder: Relatives Education And Coping Toolkit (REACT)

Lobban F, Akers N, Appelbe D, Iraci Capuccinello R, Chapman L, Collinge L, Dodd S, Flowers S, Hollingsworth B, Honary M, Johnson S, Jones SH, Mateus C, Mezes B, Murray E, Panagaki K, Rainford N, Robinson H, Rosala-Hallas A, Sellwood W, Walker A, Williamson PR
Record ID 32015001092
Authors' objectives: Psychosis and bipolar disorder are very serious mental health problems, which affect over 6 million people in the UK. Relatives (family and friends) provide the vast amount of care, which would otherwise cost the NHS over a billion pounds each year. However, this caring role also puts high levels of practical, financial and emotional strain on relatives who often struggle to cope. The UK government have made a commitment to assess the needs of relatives and provide them with the information and support they need. However, finding ways to provide this support is a challenge. Structured face to face Family Interventions have been shown to be both clinically effective (i.e. they work) for both service users and relatives, and cost effective (i.e. they are worth the cost of delivering them), but they are very hard to access in clinical services, and support for relatives is often very poor. REACT is an online toolkit that provides relatives with the information and support they need. It was co-designed with relatives, consists of easy to navigate modules, and is supported online by Expert Relatives (experts by lived experience) and peer support forums. NIHR funded the development and feasibility testing of the intervention in a small trial in the North West of England, which showed that REACT was acceptable to relatives, and reduced their distress. We have adapted the toolkit in light of feedback and designed an online trial to test its clinical and cost effectiveness across the UK. In the online trial, relatives will be directed to the study website through a wide range of routes including clinical services, voluntary sector organisations, and web searches. We plan to recruit 666 relatives who will be allocated at random to either receive access to the REACT website, or to an online Resource Directory which includes information about all currently available services. They will be asked to complete questionnaires to assess their distress levels and wellbeing at the beginning, and after 3&6 months. We will test whether there is a difference in how REACT or the Resources Directory impact on distress and wellbeing levels. Collecting the data online means that the trial costs a lot less to run (£636,204) than if it was done face to face (£2,032,667). Our team has considerable expertise in running large online trials and in supporting people with mental health problems and their relatives and we are confident we can successfully deliver this trial.
Project Status: Completed
Year Published: 2020
English language abstract: An English language summary is available
Publication Type: Not Assigned
Country: England
MeSH Terms
  • Family
  • Bipolar Disorder
  • Peer Group
  • Psychotic Disorders
  • Self Care
  • Cost-Benefit Analysis
  • Caregivers
Organisation Name: NIHR Health Technology Assessment programme
Contact Address: NIHR Journals Library, National Institute for Health Research, Evaluation, Trials and Studies Coordinating Centre, Alpha House, University of Southampton Science Park, Southampton SO16 7NS, UK
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