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Schizophrenia
A JLA Priority Setting Partnership
The JLA Schizophrenia Priority Setting Partnership (PSP) was brought together following an exercise by the University of Swansea to identify patients’, carers’ and clinicians’ uncertainties about treatments for schizophrenia, to populate a module on the UK Database of Uncertainties about the Effects of Treatments (UK DUETs). In addition, further uncertainties were identified from research recommendations and other relevant literature. The full list consisted of 237 uncertainties. The purpose of the PSP was therefore to work with patients, carers and clinicians to prioritise those uncertainties.
The Steering Group included representatives from the University of Swansea Medical School, the Cochrane Schizophrenia Group, Hafal, Rethink, the Institute of Psychiatry, the Mental Health Research Network’s Service Users in Research project, and UK DUETs.
During 2010, the PSP worked to reduce the long list of uncertainties, working with patients, carers and clinicians to rank them, resulting in a short list of 26 uncertainties. These were taken to a final priority setting workshop in January 2011, where patients, carers and clinicians came together in person, facilitated by the JLA, to discuss and rank those they felt were most important for research. A final top 10 was agreed and work is underway to disseminate this to funders and other stakeholders:
1. What is the best way to treat people with schizophrenia that is unresponsive to treatment?
2. What training is needed to recognize the early signs of recurrence?
3. Should there be compulsory community outpatient treatment for people with severe mental disorders?
4. How can sexual dysfunction due to antipsychotic-drug therapy be managed?
5. What are the benefits of supported employment for people with schizophrenia in terms of quality of life, self esteem, long-term employment prospects and illness outcomes?
6. Do the adverse effects of antipsychotic drugs outweigh the benefits?
7. What are the benefits of hospital treatment compared with home care for psychotic episodes?
8. What are the clinical benefits and cost-effectiveness of monitoring the physical health of people with schizophrenia?
9. What are the clinical, social and economic outcomes — including quality of life and the methods and effects of risk monitoring — of treatment by acute day hospitals, assertive outreach teams, in-patient units, and crisis resolution and home treatment teams?
10. What interventions could reduce weight gain in schizophrenia?
The following article Democratizing clinical research, written by Keith Lloyd and Jo White and published in Nature, highlights the prority setting process and includes the agreed top ten Schizophrenia treatment uncertainties. Article
For further information, please contact Jo White, Research Fellow, Mental Health Research Network Cymru, College of Medicine, Swansea University: J.White@swansea.ac.uk.