Can a phone app help people with schizophrenia join treatment decisions?
In 194 Danish outpatients, 6 months of a shared-decision-making app plus usual care improved patient activation (d = 0.33), communication confidence, and feeling prepared to decide, but not symptoms, hope, or admissions.
Source
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
Study at a glance
- Design
- RCT — Assessor-blinded 2-arm parallel multicenter RCT (Momentum): 6-month smartphone SDM app plus TAU vs TAU; 1:1 block randomization
- N
- N=194 · 194 participants with schizophrenia-spectrum disorders from 9 outpatient sites
- Population
- Outpatients with schizophrenia, schizotypal, or delusional disorder in the Capital Region of Denmark
- Outcome
- Primary: self-reported patient activation post-intervention; secondary: communication confidence, decision preparedness, symptoms, functioning, admissions
Structured fields used in claim comparison tables when every cited study has a complete layer.
What they did
Ran an assessor-blinded 2-arm multicenter RCT at 9 Capital Region outpatient sites. 194 people with schizophrenia, schizotypal, or delusional disorder were randomized 1:1 to TAU plus the Momentum app or TAU minus app for 6 months. Primary outcome was self-reported activation (ITT).
What they found
ITT showed higher activation (mean difference 4.39, 95% CI 0.99–7.79; d = 0.33; P = .01), communication confidence (d = 0.24), and decision preparedness (d = 0.27). No effects on satisfaction, hope, self-efficacy, alliance, symptoms, functioning, antipsychotics, or admissions.
The limits
What it doesn't show
A 6-month outpatient RCT cannot show that the app reduces relapse or works without usual care, and effects on symptoms were null.
Key terms
- Shared decision-making (SDM)
- Patient and clinician jointly making treatment choices.
- Patient activation
- Primary self-report outcome; how engaged and in control the patient feels.
- Momentum
- Name of this smartphone SDM trial/app.
- TAU
- Treatment as usual; control was TAU minus app.
- Assessor-blinded RCT
- Outcome assessors blinded; 2-arm parallel multicenter design.
- ITT
- Intention-to-treat analysis of all 194 randomized participants.
Flashcards
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Design was:
Common questions
How many people were randomized?
194.
What was the primary outcome?
Self-reported patient activation after 6 months.
Did symptoms improve?
No significant effect on symptom severity or functioning.
Effect size on activation?
Cohen d = 0.33 (mean difference 4.39).
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