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Supporting recovery in patients with psychosis using adult mental health teams (REFOCUS): a multi-site cluster randomised controlled trial

Slade, Mike; Bird, Victoria; Clarke, Eleanor; Le Boutillier, Clair; McCrone, P.; Macpherson, Rob; Pesola, Francesca; Wallace, Genevieve; Williams, Julie; Leamy, Mary

Authors

MIKE SLADE M.SLADE@NOTTINGHAM.AC.UK
Professor in Mental Health Recovery and Social Inclusion

Victoria Bird

Eleanor Clarke

Clair Le Boutillier

P. McCrone

Rob Macpherson

Francesca Pesola

Genevieve Wallace

Julie Williams

Mary Leamy



Abstract

Background: Mental health policy in many countries is oriented around recovery. The evidence base for service-level pro-recovery interventions is lacking.
Methods: Two-site cluster randomised controlled trial in England (ISRCTN02507940). REFOCUS is a one-year team-level intervention targeting staff behaviour (increasing focus on patient values, preferences, strengths, goal-striving) and staff-patient relationships (coaching, partnership). 27 community-based adult mental health teams were randomly allocated to treatment-as-usual (n=13) or treatment-as-usual plus REFOCUS (n=14). Baseline (n=403) and one-year follow-up (n=297) outcomes were assessed for randomly selected patients with psychosis, representing 88% of target recruitment. Primary outcome was recovery, assessed using Questionnaire about Processes of Recovery (QPR).
Findings: Intention-to-treat analysis using multiple imputation found no difference in QPR Total (control 40·0 (s.d.10·2), intervention 40·6 (s.d.10·1), adjusted difference 0·68, 95%CI: -1·7 to 3·1, p=·58), or sub-scales. Secondary outcomes which improved in the intervention group were functioning (adjusted difference 6·96, 95%CI 2·8 to 9·2, p

Journal Article Type Article
Journal The Lancet Psychiatry
Print ISSN 2215-0366
Electronic ISSN 2215-0374
Publisher Elsevier
Peer Reviewed Peer Reviewed
Volume 2
Issue 6
APA6 Citation Slade, M., Bird, V., Clarke, E., Le Boutillier, C., McCrone, P., Macpherson, R., …Leamy, M. (in press). Supporting recovery in patients with psychosis using adult mental health teams (REFOCUS): a multi-site cluster randomised controlled trial. Lancet Psychiatry, 2(6), https://doi.org/10.1016/S2215-0366%2815%2900086-3
DOI https://doi.org/10.1016/S2215-0366%2815%2900086-3
Publisher URL http://www.sciencedirect.com/science/article/pii/S2215036615000863
Copyright Statement Copyright information regarding this work can be found at the following address: http://eprints.nottingh.../end_user_agreement.pdf

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AFD Lancet Psychiatry REFOCUS Cost-effectiveness.pdf (671 Kb)
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Copyright Statement
Copyright information regarding this work can be found at the following address: http://eprints.nottingham.ac.uk/end_user_agreement.pdf





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