Gumley AI, Bradstreet S, Ainsworth J, Allan S, Alvarez-Jimenez M, Aucott L, Birchwood M, Briggs A, Bucci S, Cotton SM, Engel L, French P, Lederman R, Lewis S, Machin M, MacLennan G, McLeod H, McMeekin N, Mihalopoulos C, Gleeson J (2022). The EMPOWER blended digital intervention for relapse prevention in schizophrenia: a feasibility cluster randomised controlled trial in Scotland and Australia. The Lancet. Psychiatry, 9(6), 477–486. https://doi.org/10.1016/S2215-0366(22)00103-1
The study used a randomized controlled study design to evaluate feasibility of a digital intervention for relapse prevention in schizophrenia, Monitoring to Prevent relapse in psychosis and prOmote Well-being, Engagement, and Recovery (EMPOWER). Eight community mental health service (CMHS) sites in Glasgow and Melbourne were randomized to EMPOWER or treatment as usual. Participants older than 16 years of age, who had a schizophrenia diagnosis, had contact with CMHS, and had a relapse in the past two years, were recruited (N=73). EMPOWER is a blended peer and clinician support smartphone app that allows people to monitor their wellbeing and warning signs of schizophrenia relapse (i.e., a return to active schizophrenia symptoms) over a maximum of 12 months. The app includes messages to enhance self-management and autonomy and visual charts to observe changes in self-reported well-being over time. Researchers assessed feasibility, acceptability, usability, and safety through in-person interviews at the end of 12-months. Results demonstrated high rates of engagement with the app and participants reported using the app on a weekly to daily basis. Participants reported a moderate willingness (mean of 2.45 on scale of 1-4) to share their data with caregivers and staff. Overall, participants rated the app as interesting to use, easy to learn, and that the content was well written and credible. Fear of relapse was lower in the EMPOWER group than in the treatment as usual group (mean difference of -7.53 points (95% CI: 14.45 to 0.60). Results suggest the promise of EMPOWER and a next step to evaluate its effectiveness and cost-effectiveness in further research.