P0072 - SMS in the outpatient treatment of schizophrenia: Feasibility and acceptance

Abstract

Background:

In schizophrenia treatment-compliance is a strong predictor of outcome, it depends on a longer lasting therapeutic alliance. SMS (Short Message Service) sent via mobile phones is an adequate tool to establish therapeutic contingency as was shown in a study on bulimia. This programme compliments outpatient treatment and is based on an exchange of SMS-messages between patient and therapist. On a weekly basis, patients supply information on subjective well-being, sleep, social contacts, and attitude towards medication. The patient's status is then rated as improved, deteriorated, or unchanged compared to the previous week and an adequate feedback message is sent. The study aimed at assessing feasibility and acceptance of this intervention in schizophrenia patients.

Methods:

Thirty-six patients during inpatient-treatment for diagnoses of schizophrenia and schizoaffective disorder were screened and found eligible for participation. Those who agreed to participation were assessed with the SCID for DSM-IV and received instructions towards the use of the programme, which started after discharge and was designed to last for 4 months in addition to outpatient-treatment as usual.

Results:

Eight patients agreed to participation (7 male, 1 female, mean age 29 years), six of whom dropped out during the first three weeks, and only one patient completed the study.

Conclusion:

In the presented study, patients suffering from schizophrenia showed a low acceptance rate of additional SMS support complimenting their regular outpatient-treatment. As opposed to our hypothesis and contrary to experiences with bulimia patients integrating an SMS intervention into the treatment of schizophrenia does not seem feasible.