title: Effectiveness of Information Technology Aided Relapse Prevention Programme in Schizophrenia excluding the effect of user adherence: a randomized controlled trial.
abstract: BACKGROUND
  A relapse prevention program called the Information Technology Aided Relapse Prevention Programme in Schizophrenia (ITAREPS) has been developed and is reported to be highly effective. However the effectiveness was influenced by user adherence to the protocol of the program, the exact effectiveness and the role of the ITAREPS have been partially uncertain.
  
  
  OBJECTIVE
  The purpose of this study is to evaluate the effectiveness of the ITAREPS excluding the effect of user adherence to the protocol of the program.
  
  
  METHODS
  We attempted to perform a randomized controlled trial by the devised method with visiting nurse service. Outpatients with schizophrenia were randomized to the ITAREPS (n=22) or control group (n=23) and were observed for 12 months.
  
  
  RESULTS
  The risk of rehospitalization was reduced in the ITAREPS group (2 [9.1%]) compared with the control group (8 [34.8%]) (hazard ratio=0.21, 95% CI 0.04-0.99, p=0.049; number needed to treat (NNT)=4, 95% CI 2.1-35.5). The mean number of inpatient days was significantly lower in the ITAREPS group (18.5 days) compared with the control group (88.8 days) (p=0.036). The ratio of the number of rehospitalizations to that of relapses was significantly lower (p=0.035) and the mean change in total BPRS scores at relapse from baseline was significantly less in the ITAREPS group (p=0.019).
  
  
  CONCLUSIONS
  The relapse prevention effectiveness of the ITAREPS was high, and we confirmed that the ITAREPS, i.e., detecting signs of relapse and increasing medication during the warning state, is an effective intervention during the early stages of relapse.
authors.affiliation: Department of Psychiatry, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuou-ku, Chiba 260-8670, Japan. Electronic address: chibakomatsu@gmail.com.
authors.forename: Hideki
authors.initials: H
authors.lastname: Komatsu
authors.forename: Yoshimoto
authors.initials: Y
authors.lastname: Sekine
authors.forename: Naoe
authors.initials: N
authors.lastname: Okamura
authors.forename: Nobuhisa
authors.initials: N
authors.lastname: Kanahara
authors.forename: Kyoji
authors.initials: K
authors.lastname: Okita
authors.forename: Saburo
authors.initials: S
authors.lastname: Matsubara
authors.forename: Toyoaki
authors.initials: T
authors.lastname: Hirata
authors.forename: Tokutaro
authors.initials: T
authors.lastname: Komiyama
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Watanabe
authors.forename: Yoshio
authors.initials: Y
authors.lastname: Minabe
authors.forename: Masaomi
authors.initials: M
authors.lastname: Iyo
mesh_terms: D000328:Adult; D014150:Antipsychotic Agents / Q000627:therapeutic use; D005260:Female; D006760:Hospitalization; D006801:Humans; D007564:Japan; D008297:Male; D008490:Medical Informatics / Q000379:methods*; D008875:Middle Aged; D010045:Outpatients; D010359:Patient Readmission / Q000706:statistics & numerical data*; D011446:Prospective Studies; D011569:Psychiatric Status Rating Scales; D012559:Schizophrenia / Q000628:therapy*; D055502:Secondary Prevention; D018709:Statistics, Nonparametric
chemical_list: D014150:Antipsychotic Agents
keywords: ITAREPS; Information technology; Relapse prevention; Schizophrenia; Visiting nurse