Mobile After-Care Intervention to Support Post-Hospital Transition (MACS)

Study Overview
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Brief Summary
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This study examines the feasibility and acceptability of a mobile device-delivered app, called Mobile After-Care Support (MACS), to improve patients' coping and treatment adherence following a hospitalization related to their psychotic-spectrum disorder.

Detailed Description
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In the open trial, all participants will receive a study-developed app to be used on a mobile phone. This app will support the use of healthy coping skills post-hospitalization, as well as help participants adhere to their discharge treatment plan. This phase is intended to inform the feasibility and acceptability of the app in preparation for a future randomized controlled trial.

Official Title
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Mobile After-Care Support Intervention for Patients With Schizophrenia Following Hospitalization (MACS)

Conditions
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Psychotic Disorders

Intervention / Treatment
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* Behavioral: Mobile After-Care Support (MACS) app


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Currently hospitalized DSM-5 criteria for psychotic disorder (schizophrenia or schizoaffective disorder) 18 years or older Prescribed oral antipsychotic medication upon discharge Ability to speak and read English Exclusion Criteria: Alcohol/drug use disorders at moderate or severe level Planned discharge to supervised living setting or participation in formal outpatient adherence programs (e.g., medication packaging) Pregnancy or other medical condition (e.g., dementia) contraindicating use of antipsychotic medications.

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Intervention Model: Single Group Assignment
Interventional Model Description: An uncontrolled open trial approach will be used in which all participants receive the MACS app.
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Mobile After-Care Support (MACS) app<br>All participants will download the MACS app to their mobile phone (or a study provided phone, as needed). The app runs through the third-party platform, mEMA, designed by Ilumivu. It is designed to prompt engagement through questions and tailored responses at multiple times throughout the day and provide brief interventions. | Behavioral: Mobile After-Care Support (MACS) app<br>* The MACS app assesses and intervenes by fostering increased treatment adherence (medication/appointments) and self-coping with illness (active, planned, problem-solving focused) to reduce symptoms and improve functioning. Additionally, MACS encourages participants who are already reporting adherence and healthy coping by using positive reinforcement strategies to maintain efforts and promote additional goal setting. MACS app strategies are linked to participants' specific assessment responses, allowing for a highly personalized self-management intervention experience. The MACS app provides interactive exercises delivered by the device designed to teach patients coping skills that they can use now and in the future.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Client Satisfaction Questionnaire (CSQ) | The Client Satisfaction Questionnaire is a self-report measure of patient satisfaction with treatment. The total score will be used and ranges from 8 to 32 with increased scores indicating greater satisfaction with treatment. | 1 month | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Brief Psychiatric Rating Scale (BPRS) | The interviewer-rated BPRS is a measure of psychiatric symptom severity. The total score will be used to assess overall severity with scores ranging from 18 to 126 and higher scores indicating greater severity. | 1 month | 
| Brief Adherence Rating Scale (BARS) | The BARS assesses the percentage of missed medication doses over the past month. The total adherence score ranges from 0% to 100% and higher scores indicate greater adherence. | 1 month | 
| Maastricht Assessment of Coping Strategies (MACS) | The MACS is an interviewer-rated assessment of the coping strategies that patients report using to manage their symptoms. | 1 month | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Medication adherence, Treatment adherence, Ecological momentary assessment, Ecological momentary intervention, Coping skills, Psychiatric Hospitalization