E-IMR: e-health added to face-to-face delivery of Illness Management & Recovery programme for people with severe mental illness, an exploratory clustered randomized controlled trial.

Publisher: BioMed Central Country of Publication: England NLM ID: 101088677 Publication Model: Electronic Cited Medium: Internet ISSN: 1472-6963 (Electronic) Linking ISSN: 14726963 NLM ISO Abbreviation: BMC Health Serv Res Subsets: MEDLINE

Original Publication: London : BioMed Central, [2001-

Telemedicine*; Mental Disorders/*therapy; Adult ; Confounding Factors, Epidemiologic ; Female ; Humans ; Male ; Mental Disorders/surgery ; Mental Health ; Middle Aged ; Quality of Life

Background: E-mental health holds promise for people with severe mental illness, but has a limited evidence base. This study explored the effect of e-health added to face-to-face delivery of the Illness Management and Recovery Programme (e-IMR).
Method: In this multi-centre exploratory cluster randomized controlled trial, seven clusters (n = 60; 41 in intervention group and 19 in control group) were randomly assigned to e-IMR + IMR or IMR only. Outcomes of illness management, self-management, recovery, symptoms, quality of life, and general health were measured at baseline (T 0 ), halfway (T 1 ), and at twelve months (T 2 ). The data were analysed using mixed model for repeated measurements in four models: in 1) we included fixed main effects for time trend and group, in 2) we controlled for confounding effects, in 3) we controlled for interaction effects, and in 4) we performed sub-group analyses within the intervention group.
Results: Notwithstanding low activity on e-IMR, significant effects were present in model 1 analyses for self-management (p = .01) and recovery (p = .02) at T 1 , and for general health perception (p = .02) at T 2 , all in favour of the intervention group. In model 2, the confounding covariate gender explained the effects at T 1 and T 2 , except for self-management. In model 3, the interacting covariate non-completer explained the effects for self-management (p = .03) at T 1 . In model 4, the sub-group analyses of e-IMR-users versus non-users showed no differences in effect.
Conclusion: Because of confounding and interaction modifications, effectiveness of e-IMR cannot be concluded. Low use of e-health precludes definite conclusions on its potential efficacy. Low use of e-IMR calls for a thorough process evaluation of the intervention.
Trial Registration: The Dutch Trial Register ( NTR4772 ).

Int J Soc Psychiatry. 1999 Spring;45(1):7-12. (PMID: 10443245)
Nord J Psychiatry. 2005;59(4):302-6. (PMID: 16195135)
Int J Behav Med. 1996;3(2):104-22. (PMID: 16250758)
Health Serv Res. 2005 Dec;40(6 Pt 1):1918-30. (PMID: 16336556)
Schizophr Bull. 2006 Oct;32 Suppl 1:S32-43. (PMID: 16899534)
Community Ment Health J. 2007 Oct;43(5):459-80. (PMID: 17514504)
Psychiatry Res. 2008 Aug 15;160(2):228-35. (PMID: 18599126)
Int J Soc Psychiatry. 2010 Jul;56(4):424-35. (PMID: 19628556)
Adm Policy Ment Health. 2010 Jul;37(4):327-33. (PMID: 19728074)
BMJ. 2010 Mar 23;340:c869. (PMID: 20332511)
Psychiatr Serv. 2011 May;62(5):509-15. (PMID: 21532077)
Schizophr Res. 2011 Nov;132(2-3):157-64. (PMID: 21798718)
Eur Eat Disord Rev. 2012 Jul;20(4):339-42. (PMID: 22419565)
BMC Public Health. 2012 Jul 31;12:577. (PMID: 22849664)
J Med Internet Res. 2012 Nov 14;14(6):e152. (PMID: 23151820)
Int J Nurs Stud. 2013 May;50(5):587-92. (PMID: 23159157)
Int J Soc Psychiatry. 2014 Mar;60(2):162-8. (PMID: 23396286)
Tijdschr Psychiatr. 2013;55(6):427-38. (PMID: 23864410)
Psychiatry Res. 2013 Dec 30;210(3):684-9. (PMID: 24011850)
Psychiatr Serv. 2014 Jan 1;65(1):33-49. (PMID: 24129842)
BMC Public Health. 2013 Oct 30;13:1027. (PMID: 24172020)
Psychiatr Serv. 2014 Feb 1;65(2):171-9. (PMID: 24178191)
Psychiatry Res. 2014 May 15;216(2):198-205. (PMID: 24602992)
Patient Educ Couns. 2014 Dec;97(3):383-90. (PMID: 25266858)
J Ment Health. 2015;24(5):321-32. (PMID: 26017625)
Front Psychol. 2015 Jun 09;6:779. (PMID: 26106354)
Patient Educ Couns. 2015 Nov;98(11):1410-7. (PMID: 26146239)
J Ment Health. 2017 Dec;26(6):489-495. (PMID: 26754026)
BMC Health Serv Res. 2016 Jan 19;16:20. (PMID: 26782620)
J Behav Health Serv Res. 2018 Jan;45(1):1-12. (PMID: 27507243)
J Diabetes Res. 2016;2016:7386532. (PMID: 27656658)
Psychol Med. 1983 Aug;13(3):595-605. (PMID: 6622612)
Health Econ. 1993 Oct;2(3):217-27. (PMID: 8275167)
Br J Clin Psychol. 1997 Feb;36 ( Pt 1):63-72. (PMID: 9051279)

520001001 ZonMW, Netherlands Organisation for Health Care Research and Development

Keywords: E-mental health; Illness management and recovery; Severe mental illness

Date Created: 20181214 Date Completed: 20190219 Latest Revision: 20200225

20240628

PMC6292084

10.1186/s12913-018-3767-5

30541536