Newcastle University Population Health Sciences Institute, Newcastle upon Tyne, UK
Early Intervention in Psychosis service, Cumbria, Northumberland, Tyne and Wear NHS Foundation Trust, Newcastle Upon Tyne, UK.
BMJ Open. 2022 May 16;12(5):e061827. doi: 10.1136/bmjopen-2022-061827.
Hallucinations (hearing or seeing things that others do not) are a common feature of psychosis, causing significant distress and disability. Existing treatments such as cognitive-behavioural therapy for psychosis (CBTp) have modest benefits, and there is a lack of CBTp-trained staff. Shorter, targeted treatments that focus on specific symptoms delivered by a non-specialist workforce could substantially increase access to treatment.Managing Unusual Sensory Experiences (MUSE) explains why people have hallucinations and helps the person to develop and use coping strategies to reduce distress. MUSE focuses only on hallucinations, and treatment is short (four to six, 1-hour sessions per week). It is a digital intervention, run on National Health Service (NHS) laptops, which provides information about hallucinations in an engaging way, using audio, video and animated content. Crucially, it is designed for use by non-specialist staff like community psychiatric nurses.
The study is a two-arm feasibility randomised controlled trial comparing MUSE and treatment as usual (TAU) (n=40) to TAU alone (n=40), recruiting across two NHS Trusts, using 1:1 allocation and blind assessments before and after treatment (2 months) and at follow-up (3 months). Quantitative information on recruitment rates, adherence and completion of outcome assessments will be collected. Qualitative interviews will capture service users' experience of therapy and clinicians' experiences of the training and supervision in MUSE. Clinicians will also be asked about factors affecting uptake, adherence and facilitators/barriers to implementation. Analyses will focus on feasibility outcomes and provide initial estimates of intervention effects. Thematic analysis of the qualitative interviews will assess the acceptability of the training, intervention and trial procedures.
The trial has received NHS Ethical and Health Research Authority approval. Findings will be disseminated directly to participants and services, as well as through peer-reviewed publications and conference presentations.
ISRCTN16793301.
幻觉(听到或看到他人没有看到的事物)是精神病的常见特征,会引起严重的痛苦和残疾。现有的治疗方法,如精神病认知行为疗法(CBTp),效果有限,而且缺乏接受过 CBTp 培训的人员。由非专业人员提供的、更短、更有针对性、专注于特定症状的治疗方法,可以极大地增加获得治疗的机会。管理异常感官体验(MUSE)解释了为什么人们会产生幻觉,并帮助患者制定和使用应对策略来减轻痛苦。MUSE 只关注幻觉,治疗时间短(每周 4 到 6 次,每次 1 小时)。它是一种数字干预措施,在国民保健服务(NHS)笔记本电脑上运行,以吸引人的方式提供关于幻觉的信息,使用音频、视频和动画内容。至关重要的是,它是为像社区精神科护士这样的非专业人员设计的。
该研究是一项双臂可行性随机对照试验,将 MUSE 与常规治疗(TAU)(n=40)进行比较,与单独接受 TAU(n=40)进行比较,在两个 NHS 信托基金中招募参与者,采用 1:1 分配和治疗前后(2 个月)及随访(3 个月)的盲法评估。将收集关于招募率、治疗依从性和完成结果评估的定量信息。定性访谈将捕捉服务使用者对治疗的体验,以及临床医生对 MUSE 培训和监督的体验。临床医生还将被问及影响接受程度、依从性和实施的促进因素/障碍的因素。分析将侧重于可行性结果,并提供干预效果的初步估计。定性访谈的主题分析将评估培训、干预措施和试验程序的可接受性。
该试验已获得 NHS 伦理和健康研究管理局的批准。研究结果将直接向参与者和服务机构传播,并通过同行评议的出版物和会议演讲传播。
ISRCTN80314012。