Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Multicenter Study
. 2016 Dec 21;6(12):e012751.
doi: 10.1136/bmjopen-2016-012751.

Protocol for a multicentre study to assess feasibility, acceptability, effectiveness and direct costs of TRIumPH (Treatment and Recovery In PsycHosis): integrated care pathway for psychosis

Shanaya Rathod  1 , Christie Garner  1 , Alison Griffiths  2 , Borislav D Dimitrov  3 , Katherine Newman-Taylor  1   3 , Chris Woodfine  1 , Lars Hansen  1 , Paul Tabraham  1 , Karen Ward  4 , Carolyn Asher  1 , Peter Phiri  1 , Farooq Naeem  5 , Pippa North  1 , Tariq Munshi  5 , David Kingdon  3
Affiliations
Multicenter Study

Protocol for a multicentre study to assess feasibility, acceptability, effectiveness and direct costs of TRIumPH (Treatment and Recovery In PsycHosis): integrated care pathway for psychosis

Shanaya Rathod et al. BMJ Open. .

Abstract

Introduction: Duration of untreated psychosis (time between the onset of symptoms and start of treatment) is considered the strongest predictor of symptom severity and outcome. Integrated care pathways that prescribe timeframes around access and interventions can potentially improve quality of care.

Methods and analysis: A multicentre mixed methods study to assess feasibility, acceptability, effectiveness and analysis of direct costs of an integrated care pathway for psychosis. A pragmatic, non-randomised, controlled trial design is used to compare the impact of Treatment and Recovery In PsycHosis (TRIumPH; Intervention) by comparison between NHS organisations that adopt TRIumPH and those that continue with care as usual (Control). Quantitative and qualitative methods will be used. We will use routinely collected quantitative data and study-specific questionnaires and focus groups to compare service user outcomes, satisfaction and adherence to intervention between sites that adopt TRIumPH versus sites that continue with usual care pathways.

Setting: 4 UK Mental health organisations. Two will implement TRIumPH whereas two will continue care as usual.

Participants: Staff, carers, individuals accepted to early intervention in psychosis teams in participating organisations for the study period.

Intervention: TRIumPH-Integrated Care Pathway for psychosis that has a holistic approach and prescribes time frames against interventions; developed using intelligence from data; co-produced with patients, carers, clinicians and other stakeholders.

Outcomes: Feasibility will be assessed through adherence to the process measures. Satisfaction and acceptability will be assessed using questionnaires and focus groups. Effectiveness will be assessed through data collection and evaluation of patient outcomes, including clinical, functional and recovery outcomes, physical health, acute care use. Outcome measures will be assessed at baseline, 12 and 24 months to measure whether there is an effect and if so, whether this is sustained over time. Outcomes measures at the adopter sites will be compared to their own baseline and against comparator sites.

Ethics and dissemination: Ethics approval was obtained from East of Scotland Research Ethics Service (REC Ref no: LR/15/ES/0091). The results will be disseminated through publications, conference presentations, reports to the organisation.

Study registration: UK Clinical Research Network Portfolio: 19187.

Keywords: Access; Early Intervention; Integrated Care Pathway; Psychosis; co production.

PubMed Disclaimer

Conflict of interest statement

Conflicts of Interest: None declared.

Figures

Figure 1
Figure 1
TRIumPH pathway—routine referral.
Figure 2
Figure 2
TRIumPH pathway—crisis pathway.
See this image and copyright information in PMC

References

    1. Kirkbride JB, Errazuriz A, Croudace et al. . Incidence of schizophrenia and other psychoses in England, 1950–2009: a systematic review and meta-analyses. PLoS ONE 2012;7:e31660 10.1371/journal.pone.0031660 - DOI - PMC - PubMed
    1. Baldwin P, Brownie D, Scully P et al. . Epidemiology of first-episode psychosis: illustrating the challenges across diagnostic boundaries through the Cavan-Monaghan study at 8 years. Schizophr Bull 2005;31:624–38. 10.1093/schbul/sbi025 - DOI - PubMed
    1. Brown S, Kim M, Mitchell C et al. . Twenty-five year mortality of a community cohort with schizophrenia. Br J Psychiatry 2010;196:116–21. 10.1192/bjp.bp.109.067512 - DOI - PMC - PubMed
    1. World Health Organization. The World Health Report 2001. Mental Health: New Understanding, New Hope. WHO, 2001.
    1. Rössler W, Salize HJ, Van Os J et al. . Size of burden of schizophrenia and psychotic disorders. Eur Neuropsychopharmacol 2005;15:399–409. 10.1016/j.euroneuro.2005.04.009 - DOI - PubMed

LinkOut - more resources