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Schizophrenia, Schizotypal and Delusional DisordersNCT03554655

The Efficacy of Using a Smartphone App to Support Shared Decision Making in People With a Diagnosis of Schizophrenia

A study testing Momentum app in people with Schizophrenia, Schizotypal and Delusional Disorders, run by Mental Health Centre Copenhagen, Bispebjerg and Frederiksberg Hospital at 7 sites in Denmark.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

This study investigates the effects of using a smartphone app to support shared decision making (SDM) for people with schizophrenia-spectrum disorders in an outpatient treatment setting. Patients are randomized to specialized early intervention treatment with the Momentum app or without the app. Read more about this study

Who is it for?
Ages 18 to 35 years
What is being tested?
Momentum app
Type of treatment
Medical device
Could I receive a placebo?
No, everyone receives an active treatment
How many people
194 participants
Where
7 sitesDenmark
Study dates
7 Jan 2019to 30 Jan 2022
Phase
Interventional
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 to 35 years
  • All sexes
  • No healthy volunteers
  • Adult

Who may be able to join

  • Adults of both sexes aged 18+
  • A diagnosis of schizophrenia, schizotypal or delusional disorder (ICD-10 codes: F20-F29)
  • The patient have received treatment for a maximum of 18 months at the start of the intervention from one of five participating OPUS centre in the Mental Health Services of the Capital Region of Denmark

Who cannot join

  • Do not understand or speak Danish
  • Unable to give written informed consent to participate in the trial at the described terms
  • Are participating in other research studies involving OPUS treatment and an app
  • Do not have daily access to a smartphone
  • Are suffering of mental retardation or dementia (F. 70-F.79, F.00-F.03)

Trial locations and contacts

7 sites in 1 country.

7 sites in 1 country

Denmark7 sites
  • OPUS Amager

    Amager, 2300

  • OPUS Ballerup

    Ballerup Municipality, 2750

  • OPUS Glostrup

    Brøndby, 2605

  • OPUS Hvidovre

    Brøndby, 2605

  • OPUS Valby

    Brøndby, 2605

  • OPUS Hillerød

    Hillerød, 3400

  • OPUS Østerbro

    København Ø, 2100

Other trials in Denmark

About this study

Official title: The Momentum Trial: The Efficacy of Using a Smartphone Application to Support Shared Decision Making Through Patient Activation in People With a Diagnosis of Schizophrenia in Outpatient Treatment Settings

This study investigates the effects of using a smartphone app to support shared decision making (SDM) for people with schizophrenia-spectrum disorders in an outpatient treatment setting. Patients are randomized to specialized early intervention treatment with the Momentum app or without the app. The primary objective is to investigate the effect of the app on patient activation 6 months after baseline. Secondary outcomes are positive and negative symptoms, level of functioning; working alliance; self-efficacy; treatment satisfaction; hope; level of SDM; and perceived efficacy in patient-provider interaction. Explorative outcomes are self-perceived usefulness of the Momentum app.

Read the detailed description

Background:

Shared decision making (SDM) may be associated with positive health outcomes for the patient. While practitioners provide a professional expertise with information on the diagnosis, course of the illness, treatment options and potential side effects, patients are experts on their own needs, treatment preferences and goals. In mental healthcare, SDM have been assessed as a promising treatment intervention to promote patient involvement and clinical guidelines advocate the use of SDM as a patient-centered mental health care and a mean to increase patient empowerment. Although SDM today seems to be a preferred model for clinical decision-making for both patients and providers in mental health, patients indicate that they are not involved as much as they want to be in their treatment. Studies on SDM interventions for people with mental health issues are somewhat sparse and due to a small number of RCT studies, the evidence on SDM in mental health has been concluded as encouraging but inconclusive.

Based on recent research, a digital healthcare solution which links patients and providers together could assist in providing support and potentially promote SDM. Findings from existing randomized controlled trials suggest that electronic aids to support SDM are a promising mean to engage patients in their mental health treatment. Recent systematic reviews do, however, highlight a need for more evidence-based research on the efficacy and effectiveness of mental health apps.

Intervention:

Momentum is a smartphone app, developed to support people with schizophrenia-spectrum disorders to prepare for treatment consultations while becoming more involved in treatment decisions. The app was developed in the period of 2013-2014 to support SDM in the Mental Health Services of the Capital Region of Denmark in a process of co-creation. Afterwards, the app was tested by 116 mental health professionals and 78 patients from three different mental health treatment sites: community of mental health, inpatient- and outpatient treatment sites. The app has since then been optimized based on the feedback received from the study participants.

Aim:

The purpose of this trial is to investigate the effects of the smartphone app Momentum for people with a diagnosis of schizophrenia, schizotypal or delusional disorders within outpatient treatment settings in a randomized design. Our main hypothesis is that patients using the Momentum app in combination with receiving specialized early intervention treatment (i.e. treatment as usual (TAU)), compared to patients only receiving TAU, will show greater improvements in patient activation, 6 months after baseline (primary outcome). Our secondary hypothesis is that patients using the Momentum app in combination with receiving TAU, compared to patients only receiving TAU, will show greater improvements regarding self-perceived level of SDM; self-efficacy; the therapeutic alliance; hope and optimism; satisfaction with treatment; patient's confidence in communicating preferences and concerns to their provider; severity of symptoms and; level of functioning (secondary outcomes). Lastly, the investigators hypothesize that there is a correlation between the effects of using the Momentum app and self-reported usefulness of the Momentum app and/or app usage (user sessions per day, screen views per day, screens per session, session duration and session instances, user retention) (explorative outcomes).

Being tested
Momentum app
Keywords
Shared decision making, Patient activation, Schizophrenia, First-episode psychosis, mHealth, Randomized clinical trial
Medical subject headings
Schizophrenia, Schizophrenia, Paranoid, Patient Participation

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Momentum appDevice

    The Momentum system consists of a smartphone app (for the patient) and a web portal (for the provider). Information entered in the app by the patient will automatically be transferred to the web portal for the provider to see. While one goal of the system is to support SDM, the Momentum app is not a classic decision aid focusing on finding a choice to a one-off treatment decision. Instead, the Momentum app is an aid to support some of the underlying elements behind SDM such as collaboration with one's provider, awareness and eliciting of one's needs, preferences and values.

Study groups in NCT03554655
Study groupRoleWhat they receive
Intervention: Momentum appExperimentalIntervention Group will receive treatment as usual together with the Momentum app.
Receives: Device: Momentum app
ControlNo interventionControl Group will receive treatment as usual without the Momentum app.

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Change in patient activation measured with the Consumer Health Activation Index - Mental Health (CHAI-MH)

    Completed by patients. The 10-item instrument was developed based on 5 key domains: knowledge, self-efficacy, motivation and beliefs, actions, and internal locus of control. The questionnaire is rated on a 6-point Likert scale ranging from "Strongly disagree" to "Strongly agree". Afterwards, the scores are transformed into a theoretical value from 0 to 100, with higher scores signifying a stronger involvement in the treatment and confidence in the ability to take care of one's own health and health treatment.

    Measured: baseline, 3 months and end of intervention (6 months)

Secondary outcomes (15)
  1. Change in self-efficacy measured with the General Self-Efficacy scale (GSE)

    Completed by patients. The questions consists of 10 items rated on a 4-point Likert scale ranging from "not at all true" (1) to "exactly true" (4) with higher scores indicating higher self-efficacy.

    Measured: baseline, 3 months and end of intervention (6 months)

  2. Change in preparedness for decision making measured with the scale Preparation for Decision Making (PrepDM)

    Completed by patients. The 10-item instrument measures the patient's perception of how useful a decision aid or other decision support intervention is. The questionnaire is rated on a 5-point Likert scale from "Not at all" (1) to "A great deal" (5) with higher scores indicating a higher level of preparedness to communicate with one's care provider regarding health decisions.

    Measured: baseline and 6 months

  3. Change in hope measured with the Adult State Hope Scale (ASH)

    Completed by patients. The 6-item instrument is rated on a Likert-scale from 1-8, with higher scores indicating higher levels of hope.

    Measured: baseline, 3 months and end of intervention (6 months)

  4. Change in the efficacy of interactions measured with the scale Perceived Efficacy in Patient-Provider Interactions (PEPPI)

    Completed by patients. The 5-item instrument measures the assessment of patient's confidence in communicating with their physician. The questionnaire is rated on a 10-point Likert scale, with higher scores indicating higher perceived efficacy in the interactions

    Measured: baseline, 3 months and end of intervention (6 months)

  5. Change in treatment satisfaction measured with the Client Satisfaction Questionnaire (CSQ)

    Completed by patients. The 8-item instrument measures a patient's satisfaction with treatment. Each item is scored on a 4-point Likert scale, with higher scores indicating higher satisfaction.

    Measured: baseline and 6 months

  6. App Rating Questionnaire (ARQ) and usage of the Momentum app will be combined to report patients self-perceived usefulness of the app

    Completed by patients in the intervention Group. ARQ is used to measure the users experience with the app. Higher scores indicating higher perceived usefulness of the app.

    Measured: 6 months

  7. Change in treatment alliance measured with the Working Alliance Inventory - short version (WAI-S). Patient version.

    Completed by patients. The questionnaire consists of 12 items rated on a 7-point Likert scale, with higher scores indicating better self-perceived working alliance with ones provider.

    Measured: baseline and 6 months

  8. Change in treatment alliance measured with the Working Alliance Inventory - short version (WAI-S). Clinician version.

    Completed by providers.The questionnaire consists of 12 items rated on a 7-point Likert scale, with higher scores indicating better self-perceived working alliance with ones patient.

    Measured: baseline and 6 months

  9. Clinical Decision Making Style - Service user (CDMS-P)

    Completed by patients. The 21-item measures preferences in clinical decision making. The questionnaire is rated on a 5-point Likert scale with higher scores indicating a higher desire to be an active participant in decision making and to be provided with information.

    Measured: baseline

  10. Clinical Decision Making Style - Staff questionnaire (CDMS-S).

    Completed by providers. The questionnaire is rated on a 5-point Likert scale with higher scores indicating a higher desire by the clinician for active service user participation in decision making and to provide information to the service user.

    Measured: baseline

  11. Service Engagement Scale - Collaboration sub-domain only (SES)

    Completed by providers. The scale is a 14-item measurement for the provider to rate their patient's engagement level on the subscale Collaboration. Each item is scored on a 4 point Likert scale, with higher scores indicating poorer engagement.

    Measured: baseline and 6 months

  12. Change in positive symptoms measured by the Scale for the Assessment of Positive Symptoms (SAPS)

    Each dimension within SAPS is scored between 0-5 with higher scores indicating higher symptom severity

    Measured: baseline and 6 months

  13. Change in negative symptoms measured by the Scale for the Assessment of Negative Symptoms (SANS)

    Each dimension within SANS is scored between 0-5 with higher scores indicating higher symptom severity

    Measured: baseline and 6 months

  14. Change in level of functioning measured with the Global Assessment of Functioning (GAF)

    GAF assesses a person's psychosocial functioning (scores 1-100), with higher scores indicating a higher functioning level.

    Measured: baseline and 6 months

  15. Change in level of functioning measured with the Personal and Social Performance Scale (PSP)

    PSP assesses a person's functioning level within four domains; socially useful activities; Personal and social relationships; Self-care; Disturbing and aggressive behaviors. PSP is scored 1-100, with higher scores indicating a higher functioning level.

    Measured: baseline and 6 months

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted13 Jun 2018
  2. Study start7 Jan 2019
  3. Primary completion30 Sep 2021
  4. Study completion30 Jan 2022

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Supportive care
Allocation
Randomised
Intervention model
Parallel groups
Model description
A two-arm, observer-blinded, parallel group randomised controlled superiority trial will be used for this intervention. Participants will be placed in one of two groups: Intervention group: treatment as usual (TAU) together with the Momentum app or (2) Control group: TAU without the Momentum app.
Masking
Double blind
Who is masked
Investigator, Outcomes assessor
Enrolment
194 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT03554655
Sponsor's protocol ID
115441
Other IDs
H-17025550
Status last verified
Apr 2022
First submitted
30 Apr 2018
Last updated
8 Apr 2022
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Publications

  • Vitger T, Hjorthoj C, Austin SF, Petersen L, Tonder ES, Nordentoft M, Korsbek L. A Smartphone App to Promote Patient Activation and Support Shared Decision-making in People With a Diagnosis of Schizophrenia in Outpatient Treatment Settings (Momentum Trial): Randomized Controlled Assessor-Blinded Trial. J Med Internet Res. 2022 Oct 26;24(10):e40292. doi: 10.2196/40292.

    PubMed 36287604
  • Vitger T, Austin SF, Petersen L, Tonder ES, Nordentoft M, Korsbek L. The Momentum trial: the efficacy of using a smartphone application to promote patient activation and support shared decision making in people with a diagnosis of schizophrenia in outpatient treatment settings: a randomized controlled single-blind trial. BMC Psychiatry. 2019 Jun 17;19(1):185. doi: 10.1186/s12888-019-2143-2.

    PubMed 31208376

Questions about this trial

What is this clinical trial studying?

A study testing Momentum app in people with Schizophrenia, Schizotypal and Delusional Disorders, run by Mental Health Centre Copenhagen, Bispebjerg and Frederiksberg Hospital at 7 sites in Denmark.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 3 inclusion and 5 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 8 Apr 2022. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 7 sites in Denmark. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Change in patient activation measured with the Consumer Health Activation Index - Mental Health (CHAI-MH) (time frame: baseline, 3 months and end of intervention (6 months)). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT03554655, which also lists 2 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 8 Apr 2022.

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