title: 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.
abstract: 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.
  
  
  
  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.
  
  
  
  4 UK Mental health organisations. Two will implement TRIumPH whereas two will continue care as usual.
  
  
  
  Staff, carers, individuals accepted to early intervention in psychosis teams in participating organisations for the study period.
  
  
  
  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.
  
  
  
  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 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.
  
  
  
  UK Clinical Research Network Portfolio: 19187.
authors.affiliation: Southern Health NHS Foundation Trust, Calmore, Southampton, UK.
authors.forename: Shanaya
authors.initials: S
authors.lastname: Rathod
authors.affiliation: Southern Health NHS Foundation Trust, Calmore, Southampton, UK.
authors.forename: Christie
authors.initials: C
authors.lastname: Garner
authors.affiliation: Wessex Academic Health Sciences Network, Chilworth, Hampshire, UK.
authors.forename: Alison
authors.initials: A
authors.lastname: Griffiths
authors.affiliation: University of Southampton, Southampton, UK.
authors.forename: Borislav D
authors.initials: BD
authors.lastname: Dimitrov
authors.affiliation: Southern Health NHS Foundation Trust, Calmore, Southampton, UK.|University of Southampton, Southampton, UK.
authors.forename: Katherine
authors.initials: K
authors.lastname: Newman-Taylor
authors.affiliation: Southern Health NHS Foundation Trust, Calmore, Southampton, UK.
authors.forename: Chris
authors.initials: C
authors.lastname: Woodfine
authors.affiliation: Southern Health NHS Foundation Trust, Calmore, Southampton, UK.
authors.forename: Lars
authors.initials: L
authors.lastname: Hansen
authors.affiliation: Southern Health NHS Foundation Trust, Calmore, Southampton, UK.
authors.forename: Paul
authors.initials: P
authors.lastname: Tabraham
authors.affiliation: Solent NHS Trust, Southampton, UK.
authors.forename: Karen
authors.initials: K
authors.lastname: Ward
authors.affiliation: Southern Health NHS Foundation Trust, Calmore, Southampton, UK.
authors.forename: Carolyn
authors.initials: C
authors.lastname: Asher
authors.affiliation: Southern Health NHS Foundation Trust, Calmore, Southampton, UK.
authors.forename: Peter
authors.initials: P
authors.lastname: Phiri
authors.affiliation: Queens University, Kingston, Canada.
authors.forename: Farooq
authors.initials: F
authors.lastname: Naeem
authors.affiliation: Southern Health NHS Foundation Trust, Calmore, Southampton, UK.
authors.forename: Pippa
authors.initials: P
authors.lastname: North
authors.affiliation: Queens University, Kingston, Canada.
authors.forename: Tariq
authors.initials: T
authors.lastname: Munshi
authors.affiliation: University of Southampton, Southampton, UK.
authors.forename: David
authors.initials: D
authors.lastname: Kingdon
mesh_terms: D017028:Caregivers; D002985:Clinical Protocols; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D003362:Cost-Benefit Analysis; D005240:Feasibility Studies; D017144:Focus Groups; D019983:Guideline Adherence; D006297:Health Services Accessibility; D006801:Humans; D017063:Outcome Assessment, Health Care; D017060:Patient Satisfaction; D011618:Psychotic Disorders / Q000628:therapy*; D012107:Research Design; D013222:State Medicine; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D006113:United Kingdom
keywords: Access; Early Intervention; Integrated Care Pathway; Psychosis; co production