Trial Outcomes & Findings for A Concierge Model of CAE Plus LAI in Individuals With Schizophrenia at Risk for Treatment Non-adherence and Homelessness (NCT NCT02085447)

NCT ID: NCT02085447

Last Updated: 2019-12-09

Results Overview

The Tablets Routine Questionnaire (TRQ) determines the proportion of prescribed medication taken and is not dependent upon timing of medication provided that medication is consumed within the required day/24 hour period. This rating has demonstrated statistically significant association with past non-adherence, repeated past non-adherence, any non-adherence in the past month, and non-adherence in the past week. The TRQ format will be modified slightly to document all adherence values (an exact proportion) for each item. TRQ scores ranges from perfect adherence (0% missed) to missing all medication (100% missed). An average TRQ was calculated for individuals on more than one BD medication.

Recruitment status

COMPLETED

Study phase

NA

Target enrollment

30 participants

Primary outcome timeframe

Screen, Week 25

Results posted on

2019-12-09

Participant Flow

Participant milestones

Participant milestones
Measure
CAE-L
Eight sessions of the manualized intervention, Customized Adherence Enhancement (CAE), will be delivered along with a long-acting injectable antipsychotic (either haloperidol decanoate or paliperidone palmitate dosed per package insert) over the course of six weeks. Study staff will also communicate with the participant's mental health provider to help ensure treatment continuation after study end. CAE-L: Eight sessions of the manualized intervention, Customized Adherence Enhancement (CAE), will be delivered along with a long-acting injectable antipsychotic (either haloperidol decanoate or paliperidone palmitate dosed per package insert) over the course of six weeks. Study staff will also communicate with the participant's mental health provider to help ensure treatment continuation after study end.
Overall Study
STARTED
30
Overall Study
COMPLETED
26
Overall Study
NOT COMPLETED
4

Reasons for withdrawal

Withdrawal data not reported

Baseline Characteristics

A Concierge Model of CAE Plus LAI in Individuals With Schizophrenia at Risk for Treatment Non-adherence and Homelessness

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
CAE-L
n=30 Participants
Eight sessions of the manualized intervention, Customized Adherence Enhancement (CAE), will be delivered along with a long-acting injectable antipsychotic (either haloperidol decanoate or paliperidone palmitate dosed per package insert) over the course of six weeks. Study staff will also communicate with the participant's mental health provider to help ensure treatment continuation after study end. CAE-L: Eight sessions of the manualized intervention, Customized Adherence Enhancement (CAE), will be delivered along with a long-acting injectable antipsychotic (either haloperidol decanoate or paliperidone palmitate dosed per package insert) over the course of six weeks. Study staff will also communicate with the participant's mental health provider to help ensure treatment continuation after study end.
Age, Continuous
43.6 years
STANDARD_DEVIATION 9.5 • n=5 Participants
Sex: Female, Male
Female
12 Participants
n=5 Participants
Sex: Female, Male
Male
18 Participants
n=5 Participants
Race/Ethnicity, Customized
Hispanic ethnicity
2 Participants
n=5 Participants
Race/Ethnicity, Customized
Caucasian
3 Participants
n=5 Participants
Race/Ethnicity, Customized
African American
26 Participants
n=5 Participants
Region of Enrollment
United States
30 participants
n=5 Participants
Marital Status, categorical
Single, never married
21 Participants
n=5 Participants
Marital Status, categorical
Divorced
7 Participants
n=5 Participants
Marital Status, categorical
Widowed
1 Participants
n=5 Participants
Marital Status, categorical
Missing data
1 Participants
n=5 Participants
Type of Illness, categorical
Schizophrenia
6 Participants
n=5 Participants
Type of Illness, categorical
Schizoaffective disorder
24 Participants
n=5 Participants
Age of SMI (serious mental illness) onset, continuous
19.3 years
STANDARD_DEVIATION 19.4 • n=5 Participants
TRQ (Tablets Routine Questionnaire) Mean, SD
Past Week
46.5 percentage of adherence
STANDARD_DEVIATION 35.6 • n=5 Participants
TRQ (Tablets Routine Questionnaire) Mean, SD
Past Month
43.3 percentage of adherence
STANDARD_DEVIATION 32.9 • n=5 Participants
Housing status as a percentage of the previous 180 days (%, SD)
Outdoors
6.3 percentage of days
STANDARD_DEVIATION 17.0 • n=5 Participants
Housing status as a percentage of the previous 180 days (%, SD)
Short-term/emergency shelter
13.6 percentage of days
STANDARD_DEVIATION 26.8 • n=5 Participants
Housing status as a percentage of the previous 180 days (%, SD)
Transitional housing
19.2 percentage of days
STANDARD_DEVIATION 30.4 • n=5 Participants
Housing status as a percentage of the previous 180 days (%, SD)
Permanent housing with assistance
9.0 percentage of days
STANDARD_DEVIATION 26.9 • n=5 Participants
Housing status as a percentage of the previous 180 days (%, SD)
Permanent housing without assistance
37.9 percentage of days
STANDARD_DEVIATION 48.2 • n=5 Participants
Housing status as a percentage of the previous 180 days (%, SD)
Incarceration
5.8 percentage of days
STANDARD_DEVIATION 15.4 • n=5 Participants
History of substance abuse (N, %)
12 Participants
n=5 Participants
History of incarceration in the last 6 months (N, %)
9 Participants
n=5 Participants
BMI (mean, SD)
31.2 kg/m^2
STANDARD_DEVIATION 7.6 • n=5 Participants

PRIMARY outcome

Timeframe: Screen, Week 25

Population: There is missing data for some participants on the week 25 TRQ. As such, the change from screen only calculates for those who have both values, or in this case, n=16.

The Tablets Routine Questionnaire (TRQ) determines the proportion of prescribed medication taken and is not dependent upon timing of medication provided that medication is consumed within the required day/24 hour period. This rating has demonstrated statistically significant association with past non-adherence, repeated past non-adherence, any non-adherence in the past month, and non-adherence in the past week. The TRQ format will be modified slightly to document all adherence values (an exact proportion) for each item. TRQ scores ranges from perfect adherence (0% missed) to missing all medication (100% missed). An average TRQ was calculated for individuals on more than one BD medication.

Outcome measures

Outcome measures
Measure
CAE-L
n=16 Participants
Eight sessions of the manualized intervention, Customized Adherence Enhancement (CAE), will be delivered along with a long-acting injectable antipsychotic (either haloperidol decanoate or paliperidone palmitate dosed per package insert) over the course of six weeks. Study staff will also communicate with the participant's mental health provider to help ensure treatment continuation after study end. CAE-L: Eight sessions of the manualized intervention, Customized Adherence Enhancement (CAE), will be delivered along with a long-acting injectable antipsychotic (either haloperidol decanoate or paliperidone palmitate dosed per package insert) over the course of six weeks. Study staff will also communicate with the participant's mental health provider to help ensure treatment continuation after study end.
Change in Tablets Routine Questionnaire (TRQ, Past Week) From Screen to Week 25 Visit
56.2 percentage of adherence
Standard Deviation 33.6

PRIMARY outcome

Timeframe: Screen, Week 25

Population: There is missing data for some participants on the week 25 TRQ. As such, the change from screen only calculates for those who have both values, or in this case, n=15.

The Tablets Routine Questionnaire (TRQ) determines the proportion of prescribed medication taken and is not dependent upon timing of medication provided that medication is consumed within the required day/24 hour period. This rating has demonstrated statistically significant association with past non-adherence, repeated past non-adherence, any non-adherence in the past month, and non-adherence in the past week. The TRQ format will be modified slightly to document all adherence values (an exact proportion) for each item. TRQ scores ranges from perfect adherence (0% missed) to missing all medication (100% missed). An average TRQ was calculated for individuals on more than one BD medication.

Outcome measures

Outcome measures
Measure
CAE-L
n=15 Participants
Eight sessions of the manualized intervention, Customized Adherence Enhancement (CAE), will be delivered along with a long-acting injectable antipsychotic (either haloperidol decanoate or paliperidone palmitate dosed per package insert) over the course of six weeks. Study staff will also communicate with the participant's mental health provider to help ensure treatment continuation after study end. CAE-L: Eight sessions of the manualized intervention, Customized Adherence Enhancement (CAE), will be delivered along with a long-acting injectable antipsychotic (either haloperidol decanoate or paliperidone palmitate dosed per package insert) over the course of six weeks. Study staff will also communicate with the participant's mental health provider to help ensure treatment continuation after study end.
Change in Tablets Routine Questionnaire (TRQ) (Past Month) From Screen to Week 25
15.2 percentage of adherence
Standard Deviation 26.3

PRIMARY outcome

Timeframe: Week 25

Population: There is missing data for some participants. As such, the number analyzed for LAI adherence is n=16.

Long-acting injection (LAI) adherence will be determined as a proportion of LAI (paliperidone palmitate or haloperidol decanoate) injections received at the appropriate time (within 7 days of scheduled time).

Outcome measures

Outcome measures
Measure
CAE-L
n=16 Participants
Eight sessions of the manualized intervention, Customized Adherence Enhancement (CAE), will be delivered along with a long-acting injectable antipsychotic (either haloperidol decanoate or paliperidone palmitate dosed per package insert) over the course of six weeks. Study staff will also communicate with the participant's mental health provider to help ensure treatment continuation after study end. CAE-L: Eight sessions of the manualized intervention, Customized Adherence Enhancement (CAE), will be delivered along with a long-acting injectable antipsychotic (either haloperidol decanoate or paliperidone palmitate dosed per package insert) over the course of six weeks. Study staff will also communicate with the participant's mental health provider to help ensure treatment continuation after study end.
Long-acting Injection (LAI) Adherence
90.5 percentage of adherence
Standard Deviation 30.1

SECONDARY outcome

Timeframe: Screen, Week 25

Population: There is missing data for some participants on the week 25 DAI. As such, the change from screen only calculates for those who have both values, or in this case, n=23.

The DAI contains ten true-false items. Correct responses are scored as +1, while incorrect responses are scored as 0. The highest possible score is 10, while the lowest possible score is 0. Higher scores indicate better drug attitudes, while lower scores indicate worse drug attitudes.

Outcome measures

Outcome measures
Measure
CAE-L
n=23 Participants
Eight sessions of the manualized intervention, Customized Adherence Enhancement (CAE), will be delivered along with a long-acting injectable antipsychotic (either haloperidol decanoate or paliperidone palmitate dosed per package insert) over the course of six weeks. Study staff will also communicate with the participant's mental health provider to help ensure treatment continuation after study end. CAE-L: Eight sessions of the manualized intervention, Customized Adherence Enhancement (CAE), will be delivered along with a long-acting injectable antipsychotic (either haloperidol decanoate or paliperidone palmitate dosed per package insert) over the course of six weeks. Study staff will also communicate with the participant's mental health provider to help ensure treatment continuation after study end.
Change in DAI (Drug Attitudes Index) From Screen to Week 25
8.5 units on a scale
Standard Deviation 1.3

SECONDARY outcome

Timeframe: Screen, Week 25

The AMSQ/AMQ is used to measure attitudes towards medications. The scale contains 19 items. Responses which suggest positive attitudes towards medications are scored "0", while responses which suggest negative attitudes towards medications are scored "1". The items scores are added for a total score. Total scores range from 0 to 19. Lower total scores suggest more positive attitudes, while higher scores suggest more negative attitudes.

Outcome measures

Outcome measures
Measure
CAE-L
n=26 Participants
Eight sessions of the manualized intervention, Customized Adherence Enhancement (CAE), will be delivered along with a long-acting injectable antipsychotic (either haloperidol decanoate or paliperidone palmitate dosed per package insert) over the course of six weeks. Study staff will also communicate with the participant's mental health provider to help ensure treatment continuation after study end. CAE-L: Eight sessions of the manualized intervention, Customized Adherence Enhancement (CAE), will be delivered along with a long-acting injectable antipsychotic (either haloperidol decanoate or paliperidone palmitate dosed per package insert) over the course of six weeks. Study staff will also communicate with the participant's mental health provider to help ensure treatment continuation after study end.
Change in AMSQ (Attitudes Toward Mood Stabilizers Questionnaire) From Screen to Week 25
4.0 units on a scale
Standard Deviation 2.9

SECONDARY outcome

Timeframe: Screen, Week 25

Population: There is missing data for some participants on the week 25 PANSS. As such, the change from screen only calculates for those who have both values, or in this case, n=24.

The PANSS is used to assess patients for positive and negative symptoms of schizophrenia or schizoaffective disorder. The Positive Symptoms Subscale consists of 7 questions. Each item is rated on a scale of 1 (Absent) to 7 (Extreme). Total scores for the Positive Symptoms Subscale range from 7-49. Higher scores indicate more symptoms of psychopathology. There is no aggregate score for this measure, as the subscales are to be scored separately.

Outcome measures

Outcome measures
Measure
CAE-L
n=24 Participants
Eight sessions of the manualized intervention, Customized Adherence Enhancement (CAE), will be delivered along with a long-acting injectable antipsychotic (either haloperidol decanoate or paliperidone palmitate dosed per package insert) over the course of six weeks. Study staff will also communicate with the participant's mental health provider to help ensure treatment continuation after study end. CAE-L: Eight sessions of the manualized intervention, Customized Adherence Enhancement (CAE), will be delivered along with a long-acting injectable antipsychotic (either haloperidol decanoate or paliperidone palmitate dosed per package insert) over the course of six weeks. Study staff will also communicate with the participant's mental health provider to help ensure treatment continuation after study end.
Change in PANSS (Positive and Negative Syndrome Scale; Positive Symptoms Scale) From Screen to Week 25
21.2 units on a scale
Standard Deviation 5.3

SECONDARY outcome

Timeframe: Screen, Week 25

Population: There is missing data for some participants on the week 25 PANSS. As such, the change from screen only calculates for those who have both values, or in this case, n=24.

The PANSS is used to assess patients for positive and negative symptoms of schizophrenia or schizoaffective disorder. The Negative Symptoms Subscale consists of 7 questions. Each item is rated on a scale of 1 (Absent) to 7 (Extreme). Total scores for the Negative Symptoms Subscale range from 7-49. Higher scores indicate more symptoms of psychopathology. There is no aggregate score for this measure, as the subscales are to be scored separately.

Outcome measures

Outcome measures
Measure
CAE-L
n=24 Participants
Eight sessions of the manualized intervention, Customized Adherence Enhancement (CAE), will be delivered along with a long-acting injectable antipsychotic (either haloperidol decanoate or paliperidone palmitate dosed per package insert) over the course of six weeks. Study staff will also communicate with the participant's mental health provider to help ensure treatment continuation after study end. CAE-L: Eight sessions of the manualized intervention, Customized Adherence Enhancement (CAE), will be delivered along with a long-acting injectable antipsychotic (either haloperidol decanoate or paliperidone palmitate dosed per package insert) over the course of six weeks. Study staff will also communicate with the participant's mental health provider to help ensure treatment continuation after study end.
Change in PANSS (Positive and Negative Syndrome Scale; Negative Symptoms Scale) From Screen to Week 25
12.1 units on a scale
Standard Deviation 6.1

SECONDARY outcome

Timeframe: Screen, Week 25

Population: There is missing data for some participants on the week 25 PANSS. As such, the change from screen only calculates for those who have both values, or in this case, n=24.

The PANSS is used to assess patients for positive and negative symptoms of schizophrenia or schizoaffective disorder. The Composite Scale is scored by subtracting the negative score from the positive score. This yields a bipolar index that ranges from -42 to +42. The bipolar composite scale simply expresses the direction and magnitude of difference between positive and negative syndromes. Scores \>0 indicate there are more positive symptoms of schizophrenia endorsed, and scores \<0 indicate there are more negative symptoms of schizophrenia endorsed. There is no aggregate score for this measure, as the subscales are to be scored separately.

Outcome measures

Outcome measures
Measure
CAE-L
n=24 Participants
Eight sessions of the manualized intervention, Customized Adherence Enhancement (CAE), will be delivered along with a long-acting injectable antipsychotic (either haloperidol decanoate or paliperidone palmitate dosed per package insert) over the course of six weeks. Study staff will also communicate with the participant's mental health provider to help ensure treatment continuation after study end. CAE-L: Eight sessions of the manualized intervention, Customized Adherence Enhancement (CAE), will be delivered along with a long-acting injectable antipsychotic (either haloperidol decanoate or paliperidone palmitate dosed per package insert) over the course of six weeks. Study staff will also communicate with the participant's mental health provider to help ensure treatment continuation after study end.
Change in PANSS (Positive and Negative Syndrome Scale; Composite Scale) From Screen to Week 25
.8 units on a scale
Standard Deviation 6.6

SECONDARY outcome

Timeframe: Screen, Week 25

Population: There is missing data for some participants on the week 25 PANSS. As such, the change from screen only calculates for those who have both values, or in this case, n=22.

The PANSS is used to assess patients for positive and negative symptoms of schizophrenia or schizoaffective disorder. The General Psychopathology Subscale consists of 16 questions. Each item is rated on a scale of 1 (Absent) to 7 (Extreme). Total scores range from 16-112 on the General Psychopathology scale. Higher scores indicate more symptoms of psychopathology. There is no aggregate score for this measure, as the subscales are to be scored separately.

Outcome measures

Outcome measures
Measure
CAE-L
n=22 Participants
Eight sessions of the manualized intervention, Customized Adherence Enhancement (CAE), will be delivered along with a long-acting injectable antipsychotic (either haloperidol decanoate or paliperidone palmitate dosed per package insert) over the course of six weeks. Study staff will also communicate with the participant's mental health provider to help ensure treatment continuation after study end. CAE-L: Eight sessions of the manualized intervention, Customized Adherence Enhancement (CAE), will be delivered along with a long-acting injectable antipsychotic (either haloperidol decanoate or paliperidone palmitate dosed per package insert) over the course of six weeks. Study staff will also communicate with the participant's mental health provider to help ensure treatment continuation after study end.
Change in PANSS (Positive and Negative Syndrome Scale; General Psychopathology) From Screen to Week 25
24.7 units on a scale
Standard Deviation 6.4

SECONDARY outcome

Timeframe: Screen, Week 25

Population: There is missing data for some participants on the week 25 CGI. As such, the change from screen only calculates for those who have both values, or in this case, n=22.

The CGI evaluates global psychopathology illness severity on a 7 point Likert Scale (minimum score = 1; maximum score = 7) with higher scores indicating worse pathology.

Outcome measures

Outcome measures
Measure
CAE-L
n=22 Participants
Eight sessions of the manualized intervention, Customized Adherence Enhancement (CAE), will be delivered along with a long-acting injectable antipsychotic (either haloperidol decanoate or paliperidone palmitate dosed per package insert) over the course of six weeks. Study staff will also communicate with the participant's mental health provider to help ensure treatment continuation after study end. CAE-L: Eight sessions of the manualized intervention, Customized Adherence Enhancement (CAE), will be delivered along with a long-acting injectable antipsychotic (either haloperidol decanoate or paliperidone palmitate dosed per package insert) over the course of six weeks. Study staff will also communicate with the participant's mental health provider to help ensure treatment continuation after study end.
Change in CGI (Clinical Global Impression) From Screen to Week 25
2.9 units on a scale
Standard Deviation .8

SECONDARY outcome

Timeframe: Screen, Week 25

Population: There is missing data for some participants on the week 25 ASSIST. As such, the change from screen only calculates for those who have both values, or in this case, n=20.

The ASSIST was used to measure drug use. A total score is derived by combining item scores (minimum score = 0; maximum score = 382). Higher scores indicate higher risk of lifestyle problems, including health.

Outcome measures

Outcome measures
Measure
CAE-L
n=20 Participants
Eight sessions of the manualized intervention, Customized Adherence Enhancement (CAE), will be delivered along with a long-acting injectable antipsychotic (either haloperidol decanoate or paliperidone palmitate dosed per package insert) over the course of six weeks. Study staff will also communicate with the participant's mental health provider to help ensure treatment continuation after study end. CAE-L: Eight sessions of the manualized intervention, Customized Adherence Enhancement (CAE), will be delivered along with a long-acting injectable antipsychotic (either haloperidol decanoate or paliperidone palmitate dosed per package insert) over the course of six weeks. Study staff will also communicate with the participant's mental health provider to help ensure treatment continuation after study end.
Change in ASSIST GRS (Alcohol, Smoking and Substance Involvement Screening Test ) From Screen to Week 25
2.0 units on a scale
Standard Deviation 2.5

SECONDARY outcome

Timeframe: Screen, Week 25

Evaluates social and occupational functioning on a scale of 0 (Inadequate information) to 100 (Superior functioning). It is a one-item measure.

Outcome measures

Outcome measures
Measure
CAE-L
n=26 Participants
Eight sessions of the manualized intervention, Customized Adherence Enhancement (CAE), will be delivered along with a long-acting injectable antipsychotic (either haloperidol decanoate or paliperidone palmitate dosed per package insert) over the course of six weeks. Study staff will also communicate with the participant's mental health provider to help ensure treatment continuation after study end. CAE-L: Eight sessions of the manualized intervention, Customized Adherence Enhancement (CAE), will be delivered along with a long-acting injectable antipsychotic (either haloperidol decanoate or paliperidone palmitate dosed per package insert) over the course of six weeks. Study staff will also communicate with the participant's mental health provider to help ensure treatment continuation after study end.
Change in SOFAS (Social and Occupational Functioning Assessment Scale) From Screen to Week 25
63.1 units on a scale
Standard Deviation 8.7

SECONDARY outcome

Timeframe: Baseline, Week 25

The AIMS is used to monitor for the development of involuntary movements that may occur as a result of certain psychotropic medication. It contains 14 items, 10 of which are rated on a scale of 0 (None) to 4 (Severe). The remaining four items are "yes or no" questions. Items 1 thru 7 are added for a total score, while item 8 is used as an overall severity index. Total scores range from 0 to 28. Higher scores indicate more adverse outcomes.Items 9 thru 12 provide additional information that may be useful in determining lip, jaw, and tongue movements.

Outcome measures

Outcome measures
Measure
CAE-L
n=23 Participants
Eight sessions of the manualized intervention, Customized Adherence Enhancement (CAE), will be delivered along with a long-acting injectable antipsychotic (either haloperidol decanoate or paliperidone palmitate dosed per package insert) over the course of six weeks. Study staff will also communicate with the participant's mental health provider to help ensure treatment continuation after study end. CAE-L: Eight sessions of the manualized intervention, Customized Adherence Enhancement (CAE), will be delivered along with a long-acting injectable antipsychotic (either haloperidol decanoate or paliperidone palmitate dosed per package insert) over the course of six weeks. Study staff will also communicate with the participant's mental health provider to help ensure treatment continuation after study end.
Change in AIMS (Abnormal Involuntary Movement Scale) From Baseline to Week 25
1.5 units on a scale
Standard Deviation 2.5

SECONDARY outcome

Timeframe: Screen, Week 25

Population: There is missing data for some participants on the week 25 SAS. As such, the change from screen only calculates for those who have both values, or in this case, n=20.

The Simpson-Angus Scale is used to monitor for neurological and musculoskeletal side effects that may be a result of certain psychotropic medications. The scale consists of 10 questions which each can be rated on a scale of 0 to 4. Scores for each item are added to produce a total score. Total scores range from 0 to 40. Higher scores indicate more adverse outcomes.

Outcome measures

Outcome measures
Measure
CAE-L
n=20 Participants
Eight sessions of the manualized intervention, Customized Adherence Enhancement (CAE), will be delivered along with a long-acting injectable antipsychotic (either haloperidol decanoate or paliperidone palmitate dosed per package insert) over the course of six weeks. Study staff will also communicate with the participant's mental health provider to help ensure treatment continuation after study end. CAE-L: Eight sessions of the manualized intervention, Customized Adherence Enhancement (CAE), will be delivered along with a long-acting injectable antipsychotic (either haloperidol decanoate or paliperidone palmitate dosed per package insert) over the course of six weeks. Study staff will also communicate with the participant's mental health provider to help ensure treatment continuation after study end.
Change in SAS (Simpson Angus Scale) From Screen to Week 25
0.0 units on a scale
Standard Deviation 0.2

SECONDARY outcome

Timeframe: Screen, Week 25

Population: There is missing data for some participants on the week 25 BARS. As such, the change from screen only calculates for those who have both values, or in this case, n=20.

This scale is used to measure the presence of akathisia, as may result from use of certain psychotropic medications. The scale contains four items and the score for each item is added to produce the total score. Total scores range from 0 to 14. Higher scores indicate more adverse outcomes.

Outcome measures

Outcome measures
Measure
CAE-L
n=20 Participants
Eight sessions of the manualized intervention, Customized Adherence Enhancement (CAE), will be delivered along with a long-acting injectable antipsychotic (either haloperidol decanoate or paliperidone palmitate dosed per package insert) over the course of six weeks. Study staff will also communicate with the participant's mental health provider to help ensure treatment continuation after study end. CAE-L: Eight sessions of the manualized intervention, Customized Adherence Enhancement (CAE), will be delivered along with a long-acting injectable antipsychotic (either haloperidol decanoate or paliperidone palmitate dosed per package insert) over the course of six weeks. Study staff will also communicate with the participant's mental health provider to help ensure treatment continuation after study end.
Change in BARS (Barnes Akathisia Rating Scale) From Screen to Week 25
.3 units on a scale
Standard Deviation 1.3

SECONDARY outcome

Timeframe: Screen, Week 25

Population: There is missing data for some participants on the week 25 ESRS-A. As such, the change from screen only calculates for those who have both values, or in this case, n=20.

For the subjective examination scoring is on a 4-point scale (0=Absent;1=Mild, 2=Moderate, 3=Severe). The evaluator takes into account the verbal report of the patient on: 1) the frequency and duration of the symptom during the day; 2) the number of days the symptom was present during the last week; and, 3) the subjective evaluation of the intensity of the symptom by the patient. The score for Parkinsonism (including akathisia), ranges from 0 to 102 (17 items), and is based on all items of the Parkinsonism examination: tremor (0-48), gait and posture (0-6), postural stability (0-6), rigidity (0-24), expressive automatic movements (0-6), bradykinesia (0-6), akathisia (0-6). Higher scores indicate more severity.

Outcome measures

Outcome measures
Measure
CAE-L
n=20 Participants
Eight sessions of the manualized intervention, Customized Adherence Enhancement (CAE), will be delivered along with a long-acting injectable antipsychotic (either haloperidol decanoate or paliperidone palmitate dosed per package insert) over the course of six weeks. Study staff will also communicate with the participant's mental health provider to help ensure treatment continuation after study end. CAE-L: Eight sessions of the manualized intervention, Customized Adherence Enhancement (CAE), will be delivered along with a long-acting injectable antipsychotic (either haloperidol decanoate or paliperidone palmitate dosed per package insert) over the course of six weeks. Study staff will also communicate with the participant's mental health provider to help ensure treatment continuation after study end.
Change in ESRS-A (Extrapyramidal Symptoms Scale-Abbreviated; Parkinsonism) From Screen to Week 25
0.0 units on a scale
Standard Deviation 0.2

SECONDARY outcome

Timeframe: Screen, Week 25

Population: There is missing data for some participants on the week 25 ESRS-A. As such, the change from screen only calculates for those who have both values, or in this case, n=20.

For the subjective examination scoring is on a 4-point scale (0=Absent;1=Mild, 2=Moderate, 3=Severe). The evaluator takes into account the verbal report of the patient on: 1) the frequency and duration of the symptom during the day; 2) the number of days the symptom was present during the last week; and, 3) the subjective evaluation of the intensity of the symptom by the patient. The score for dystonia ranges from 0 to 60 (10 items), and is formed by including both acute and chronic dystonia, based on the dystonia examination. Higher scores indicate more severity.

Outcome measures

Outcome measures
Measure
CAE-L
n=20 Participants
Eight sessions of the manualized intervention, Customized Adherence Enhancement (CAE), will be delivered along with a long-acting injectable antipsychotic (either haloperidol decanoate or paliperidone palmitate dosed per package insert) over the course of six weeks. Study staff will also communicate with the participant's mental health provider to help ensure treatment continuation after study end. CAE-L: Eight sessions of the manualized intervention, Customized Adherence Enhancement (CAE), will be delivered along with a long-acting injectable antipsychotic (either haloperidol decanoate or paliperidone palmitate dosed per package insert) over the course of six weeks. Study staff will also communicate with the participant's mental health provider to help ensure treatment continuation after study end.
Change in ESRS-A (Extrapyramidal Symptoms Scale-Abbreviated; Dystonia) From Screen to Week 25
0.0 units on a scale
Standard Deviation 0.0

SECONDARY outcome

Timeframe: Screen, Week 25

Population: There is missing data for some participants on the week 25 ESRS-A. As such, the change from screen only calculates for those who have both values, or in this case, n=20.

For the subjective examination scoring is on a 4-point scale (0=Absent;1=Mild, 2=Moderate, 3=Severe). The evaluator takes into account the verbal report of the patient on: 1) the frequency and duration of the symptom during the day; 2) the number of days the symptom was present during the last week; and, 3) the subjective evaluation of the intensity of the symptom by the patient. Score for TD, ranging from 0 to 42, is based on the sum of all seven items in the TD objective examination. Higher scores indicate more severe symptomology.

Outcome measures

Outcome measures
Measure
CAE-L
n=20 Participants
Eight sessions of the manualized intervention, Customized Adherence Enhancement (CAE), will be delivered along with a long-acting injectable antipsychotic (either haloperidol decanoate or paliperidone palmitate dosed per package insert) over the course of six weeks. Study staff will also communicate with the participant's mental health provider to help ensure treatment continuation after study end. CAE-L: Eight sessions of the manualized intervention, Customized Adherence Enhancement (CAE), will be delivered along with a long-acting injectable antipsychotic (either haloperidol decanoate or paliperidone palmitate dosed per package insert) over the course of six weeks. Study staff will also communicate with the participant's mental health provider to help ensure treatment continuation after study end.
Change in ESRS-A (Extrapyramidal Symptoms Scale-Abbreviated; Dyskinesia) From Screen to Week 25
1.4 units on a scale
Standard Deviation 2.2

SECONDARY outcome

Timeframe: Screen, Week 25

Population: There is missing data for some participants on the week 25 ESRS-A. As such, the change from screen only calculates for those who have both values, or in this case, n=20.

For the subjective examination scoring is on a 4-point scale (0=Absent;1=Mild, 2=Moderate, 3=Severe). The evaluator takes into account the verbal report of the patient on: 1) the frequency and duration of the symptom during the day; 2) the number of days the symptom was present during the last week; and, 3) the subjective evaluation of the intensity of the symptom by the patient. The score for akathisia is separated from the Parkinsonism score and is based on the combined score of subjective akathisia (item 6 of the questionnaire) and objective akathisia (item 7 of the Parkinsonism/Akathisia objective examination). This subscore total ranges from 0 to 6. Higher scores indicate more severity.

Outcome measures

Outcome measures
Measure
CAE-L
n=20 Participants
Eight sessions of the manualized intervention, Customized Adherence Enhancement (CAE), will be delivered along with a long-acting injectable antipsychotic (either haloperidol decanoate or paliperidone palmitate dosed per package insert) over the course of six weeks. Study staff will also communicate with the participant's mental health provider to help ensure treatment continuation after study end. CAE-L: Eight sessions of the manualized intervention, Customized Adherence Enhancement (CAE), will be delivered along with a long-acting injectable antipsychotic (either haloperidol decanoate or paliperidone palmitate dosed per package insert) over the course of six weeks. Study staff will also communicate with the participant's mental health provider to help ensure treatment continuation after study end.
Change in ESRS-A (Extrapyramidal Symptoms Scale-Abbreviated; Akathisia)
.2 units on a scale
Standard Deviation .9

SECONDARY outcome

Timeframe: Screen, Week 25

Change in number of psychiatric hospitalizations from the past 6 months from Screen and Week 25. This is calculated by subtracting the number of psychiatric hospitalizations at screen from the number of psychiatric hospitalizations at week 25.

Outcome measures

Outcome measures
Measure
CAE-L
n=26 Participants
Eight sessions of the manualized intervention, Customized Adherence Enhancement (CAE), will be delivered along with a long-acting injectable antipsychotic (either haloperidol decanoate or paliperidone palmitate dosed per package insert) over the course of six weeks. Study staff will also communicate with the participant's mental health provider to help ensure treatment continuation after study end. CAE-L: Eight sessions of the manualized intervention, Customized Adherence Enhancement (CAE), will be delivered along with a long-acting injectable antipsychotic (either haloperidol decanoate or paliperidone palmitate dosed per package insert) over the course of six weeks. Study staff will also communicate with the participant's mental health provider to help ensure treatment continuation after study end.
Change in Hospitalizations (Psychiatric) in the Past 6 Months From Screen and Week 25
.2 hospital visits
Standard Deviation .4

SECONDARY outcome

Timeframe: Screen, Week 25

Change in number of psychiatric hospitalizations from the past 6 months from Screen and Week 25. This is calculated by subtracting the number of psychiatric hospitalizations at screen from the number of psychiatric hospitalizations at week 25.

Outcome measures

Outcome measures
Measure
CAE-L
n=26 Participants
Eight sessions of the manualized intervention, Customized Adherence Enhancement (CAE), will be delivered along with a long-acting injectable antipsychotic (either haloperidol decanoate or paliperidone palmitate dosed per package insert) over the course of six weeks. Study staff will also communicate with the participant's mental health provider to help ensure treatment continuation after study end. CAE-L: Eight sessions of the manualized intervention, Customized Adherence Enhancement (CAE), will be delivered along with a long-acting injectable antipsychotic (either haloperidol decanoate or paliperidone palmitate dosed per package insert) over the course of six weeks. Study staff will also communicate with the participant's mental health provider to help ensure treatment continuation after study end.
Change in Hospitalizations (Medical) in the Past 6 Months From Screen and Week 25
.2 hospital visits
Standard Deviation .4

SECONDARY outcome

Timeframe: Screen, Week 25

Population: There is missing data for some participants on the week 25 housing status. As such, the change from screen only calculates for those who have both values, or in this case, n=20.

Change in number of sub-optimal housing from the past 6 months from Screen and Week 25. This is calculated by subtracting the percent of sub-optimal housing at screen from the number of sub-optimal housing at week 25.

Outcome measures

Outcome measures
Measure
CAE-L
n=20 Participants
Eight sessions of the manualized intervention, Customized Adherence Enhancement (CAE), will be delivered along with a long-acting injectable antipsychotic (either haloperidol decanoate or paliperidone palmitate dosed per package insert) over the course of six weeks. Study staff will also communicate with the participant's mental health provider to help ensure treatment continuation after study end. CAE-L: Eight sessions of the manualized intervention, Customized Adherence Enhancement (CAE), will be delivered along with a long-acting injectable antipsychotic (either haloperidol decanoate or paliperidone palmitate dosed per package insert) over the course of six weeks. Study staff will also communicate with the participant's mental health provider to help ensure treatment continuation after study end.
Percentage Change of Days of Sub-optimal Housing in the Past Six Months; Change From Screen to Week 25
29.0 percentage of days
Standard Deviation 38.2

Adverse Events

CAE-L

Serious events: 7 serious events
Other events: 0 other events
Deaths: 0 deaths

Serious adverse events

Serious adverse events
Measure
CAE-L
n=30 participants at risk
Eight sessions of the manualized intervention, Customized Adherence Enhancement (CAE), will be delivered along with a long-acting injectable antipsychotic (either haloperidol decanoate or paliperidone palmitate dosed per package insert) over the course of six weeks. Study staff will also communicate with the participant's mental health provider to help ensure treatment continuation after study end. CAE-L: Eight sessions of the manualized intervention, Customized Adherence Enhancement (CAE), will be delivered along with a long-acting injectable antipsychotic (either haloperidol decanoate or paliperidone palmitate dosed per package insert) over the course of six weeks. Study staff will also communicate with the participant's mental health provider to help ensure treatment continuation after study end.
Injury, poisoning and procedural complications
fall
3.3%
1/30 • Number of events 1 • 6 months
Musculoskeletal and connective tissue disorders
hernia
3.3%
1/30 • Number of events 1 • 6 months
Respiratory, thoracic and mediastinal disorders
COPD exacerbation
3.3%
1/30 • Number of events 1 • 6 months
Infections and infestations
frostbite
3.3%
1/30 • Number of events 1 • 6 months
Infections and infestations
spider bite
3.3%
1/30 • Number of events 1 • 6 months
Hepatobiliary disorders
acute alcoholic hepatitis
3.3%
1/30 • Number of events 1 • 6 months
Psychiatric disorders
psychiatric hospitalization due to suicidal ideation
3.3%
1/30 • Number of events 1 • 6 months

Other adverse events

Adverse event data not reported

Additional Information

Dr. Martha Sajatovic

University Hospitals Cleveland Medical Center

Phone: 2168442808

Results disclosure agreements

  • Principal investigator is a sponsor employee
  • Publication restrictions are in place