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Greenwood K, Webb R, Gu J, Fowler D, de Visser R, Bremner S, Abramowicz I, Perry N, Clark S, O'Donnell A, Charlton D, Jarvis R, Garety P, Nandha S, Lennox B, Johns L, Rathod S, Phiri P, French P, Law H, Hodgekins J, Painter M, Treise C, Plaistow J, Irwin F, Thompson R, Mackay T, May CR, Healey A, Hooper R, Peters E. The Early Youth Engagement in first episode psychosis (EYE-2) study: pragmatic cluster randomised controlled trial of implementation, effectiveness and cost-effectiveness of a team-based motivational engagement intervention to improve engagement. Trials 2021; 22:272. [PMID: 33845856 PMCID: PMC8042707 DOI: 10.1186/s13063-021-05105-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Accepted: 02/06/2021] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Early Intervention in Psychosis (EIP) services improve health outcomes for young people with psychosis in the medium-long term, but 25% of young people disengage in the first 12 months with costs to their mental health, families, society and the NHS. This study will evaluate the effectiveness, cost-effectiveness and implementation of a team-based motivational Early Youth Engagement (EYE-2) intervention. METHOD The study design is a cluster randomised controlled trial (RCT) with economic evaluation, comparing the EYE-2 intervention + standardised EIP service to standardised EIP service alone, with randomisation at the team level. A process evaluation will evaluate the delivery of the intervention qualitatively and quantitatively across contexts. The setting is 20 EIP teams in 5 sites: Manchester, South London, East Anglia, Thames Valley and Hampshire. Participants are young people (14-35 years) with first episode psychosis, and EIP staff. The intervention is the team-based motivational engagement (EYE-2) intervention, delivered alongside standardised EIP services, and supported by additional training, website, booklets and social groups. The comparator is the standardised EIP service. Both interventions are delivered by EIP clinicians. The primary outcome is time to disengagement (time in days from date of allocation to care coordinator to date of last contact following refusal to engage with EIP service, or lack of response to EIP contact for a consecutive 3-month period). Secondary outcomes include mental and physical health, deaths, social and occupational function, recovery, satisfaction and service use at 6, 12, 18 and 24 months. A 12-month within-trial economic evaluation will investigate cost-effectiveness from a societal perspective and from an NHS perspective. DISCUSSION The trial will provide the first test of an engagement intervention in standardised care, with the potential for significant impact on the mental health and wellbeing of young people and their families, and economic benefits for services. The intervention will be highly scalable, supported by the toolkit including manuals, commissioning guide, training and resources, adapted to meet the needs of the diverse EIP population, and based on an in-depth process evaluation. TRIAL REGISTRATION ISRCTN 51629746 prospectively registered 7th May 2019. Date assigned 10th May 2019.
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Affiliation(s)
- Kathryn Greenwood
- R&D, Sussex Partnership NHS Foundation Trust, Hove, UK. .,School of Psychology, University of Sussex, Falmer, UK.
| | - Rebecca Webb
- School of Psychology, University of Sussex, Falmer, UK
| | - Jenny Gu
- School of Psychology, University of Sussex, Falmer, UK
| | - David Fowler
- R&D, Sussex Partnership NHS Foundation Trust, Hove, UK.,School of Psychology, University of Sussex, Falmer, UK.,University of East Anglia, Norwich, UK
| | | | - Stephen Bremner
- Brighton and Sussex Medical School, University of Sussex, Falmer, UK
| | - Iga Abramowicz
- Brighton and Sussex Medical School, University of Sussex, Falmer, UK
| | - Nicky Perry
- Brighton and Sussex University Hospitals NHS Trust, Brighton, UK
| | - Stuart Clark
- Sussex Partnership NHS Foundation Trust, Hove, UK
| | | | - Dan Charlton
- Sussex Partnership NHS Foundation Trust, Hove, UK
| | | | - Philippa Garety
- King's College London, Institute of Psychiatry Psychology and Neuroscience, London, UK.,South London and Maudsley NHS Foundation Trust, London, UK
| | - Sunil Nandha
- South London and Maudsley NHS Foundation Trust, London, UK
| | - Belinda Lennox
- Department of Psychiatry, University of Oxford, Oxford, UK.,Oxford Health NHS Foundation Trust, Oxford, UK
| | - Louise Johns
- Department of Psychiatry, University of Oxford, Oxford, UK.,Oxford Health NHS Foundation Trust, Oxford, UK
| | | | - Peter Phiri
- Southern Health NHS Foundation Trust, Southampton, UK
| | - Paul French
- Pennine Care NHS Foundation Trust, Ashton-under-Lyne, UK.,Manchester Metropolitan University, Manchester, UK
| | - Heather Law
- Greater Manchester Mental Health NHS Foundation Trust, Greater Manchester, UK
| | | | | | - Cate Treise
- Cambridge and Peterborough NHS Foundation Trust, Cambridge, UK
| | | | - Francis Irwin
- Norfolk and Suffolk NHS Foundation Trust, Norwich, UK
| | | | | | - Carl R May
- Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, UK
| | - Andy Healey
- King's College London, Institute of Psychiatry Psychology and Neuroscience, London, UK
| | - Richard Hooper
- Institute of Population Health Sciences, Queen Mary University of London, London, UK
| | - Emmanuelle Peters
- King's College London, Institute of Psychiatry Psychology and Neuroscience, London, UK.,South London and Maudsley NHS Foundation Trust, London, UK
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