Boston University College of Health & Rehabilitation Sciences:
Sargent College

Boston University College of Health & Rehabilitation Sciences: Sargent College

Improving Quality and Reducing Costs in Schizophrenia Care with New Technologies and New Personnel

Funding:

Center for Medicaid/Medicare Innovation (CMMI) Grant

Dates:

2012 - 2015

Description

The goal of this project was to improve illness management and the overall process of care in treating schizophrenia in order to reduce ER visits and hospital days while providing better care and better health. This was done by fostering innovation in the use of technology and by training and deploying Mental Health/Health Technology (MH/HT) Case Managers at 10 community mental health agencies around the country.

The components of the treatment model included: 1) evidence-based pharmacological treatment facilitated by a web-based prescriber decision support system (Prescriber Decision Assistant or PDA); 2) brief, in-person, relapse prevention counseling with supplemental web-based learning modules; 3) Technology to Extend Care and Support to Schizophrenia (TECSS), a program that offers web- and phone-based resources to support persons with schizophrenia and their family members or others.

 

The resources included a patient and family Psycho-Education Treatment program, which includes electronic peer groups facilitated by mental health professionals, providing medication reminders via web and phone, and conducting monitoring of early warning signs of relapse via web and phone 4) an interactive smartphone application to support medication adherence, facilitate coping with symptoms and improve daily functioning in individuals with schizophrenia and 5) a web-based, self-administered cognitive-behavioral therapy (CBT) program for the management of auditory hallucinations and paranoia; and 6) medication sensor technology to monitor adherence will be utilized in a subset of patients. All participants were provided with pharmacological treatment (PDA), brief in-person relapse prevention counseling, and the smartphone application. The other program components were provided to patients using a shared decision-making approach to assess need and preference.

Our target population was persons between the ages of 18 and 50 with a diagnosis of schizophrenia or schizoaffective disorder who had a history of two or more prior hospitalizations, with at least one having occurred in the year previous to enrollment and who are currently enrolled in (or eligible for) a Medicaid program or are uninsured. Such individuals have been shown to be at high risk for rehospitalization and high costs of care. This project was 3 years in duration, with participants receiving active treatment for a period of 6 months.

Investigators

Site Principal Investigator: Jennifer Gottlieb, Ph.D. (No longer at the Center)
Co-Investigator: Kim T. Mueser, Ph.D.
Co-Investigator: Susan Gingerich, MSW, Independent Consultant
BU Project Coordinators: Vasudha Gidugu, M.A. and Mihoko Maru, M.A.

This is a multi-site study. Please contact the Center investigator for additional information.

Documents

Ben-Zeev D, Scherer EA, Gottlieb JD, Rotondi AJ, Brunette MF, Achtyes ED, Mueser KT, Gingerich S, Brenner CJ, Begale M, Mohr DC, Schooler N, Marcy P, Robinson DG, Kane JM. (2016). mHealth for Schizophrenia: Patient Engagement With a Mobile Phone Intervention Following Hospital Discharge. JMIR Mental Health. 27;3(3):e34. doi: 10.2196/mental.6348.

Baumel A, Correll CU, Hauser M, Brunette M, Rotondi A, Ben-Zeev D, Gottlieb JD, Mueser KT, Achtyes ED, Schooler NR, Robinson DG, Gingerich S, Marcy P, Meyer-Kalos P, Kane JM. (2016). Health Technology Intervention After Hospitalization for Schizophrenia: Service Utilization and User Satisfaction.  Psychiatric Services. 67(9):1035-8. doi: 10.1176/appi.ps.201500317. Epub 2016 Jun 1.

Brunette MF, Rotondi AJ, Ben-Zeev D, Gottlieb JD, Mueser KT, Robinson DG, Achtyes ED, Gingerich S, Marcy P, Schooler NR, Meyer-Kalos P, Kane JM. (2016). Coordinated Technology-Delivered Treatment to Prevent Rehospitalization in Schizophrenia: A Novel Model of Care. Psychiatric Services. 67(4):444-7. https://ps.psychiatryonline.org/doi/10.1176/appi.ps.201500257

 

 

Contact

Inquiries related to the project should be addressed to:

Kim Mueser, Ph.D.
Boston University, Center for Psychiatric Rehabilitation
940 Commonwealth Avenue West, 2nd Floor
Boston, MA 02215