Relapse in schizophrenia is a major cause of distress and disability amongst patients and their families. Relapse is predicted by changes in symptoms such as anxiety, depression and suspiciousness. These so-called early warning signs (EWS) can be used as the basis to promote timely interventions to prevent relapse and hospitalization. However, many individuals experience a fear of relapse, which can block accessing timely support. Our approach builds on helping individuals become more attuned to changes in their thoughts, feelings and experiences of psychosis in daily life to support improved awareness and self-management.

The EMPOWER team have developed a smartphone App (the EMPOWER App). The EMPOWER App prompts people on a daily basis to respond to a set of questions that relate to how they are feeling. Based on each individual’s own personal baseline score, the EMPOWER App can then calculate changes in wellbeing to prompt self-management or to enable access to timely access to further support. 

The EMPOWER trial, funded by the NIHR HTA Programme and the Australian Government National Health and Medical Research Council, will evaluate the EMPOWER App against treatment as usual, using a multicentre, two arm, parallel group, cluster randomised controlled design involving eight purposively selected Community Mental Health Services (6 in Glasgow and 2 in Melbourne). Eligible patients are adults with a diagnosis of Schizophrenia-related disorder who have either been admitted to a psychiatric in-patient service at least once in the previous two years for relapse of psychosis or have received crisis intervention in the previous two years for a relapse of psychosis. The primary outcome is relapse over a 12 month follow-up period.

The study is now complete and will report results in late 2020 or in 2021. The EMPOWER trial is led by Professor Andrew Gumley of the University of Glasgow.





The trial protocol has been published - https://www.researchprotocols.org/2020/1/e15058/