The Comquol Study
Recently completed research, led by Professor Douglas MacInnes, has indicated that an innovative new intervention focused on developing collaborative working between service users and health care practitioners, in secure mental health facilities, has resulted in the trial design being viewed as viable as the basis for a large full-scale trial with no refinements needed to the intervention.
The estimated treatment effect of the primary outcome (quality of life) is clinically important and the estimated overall summary mean scores indicate a positive effect of the intervention is not ruled out. A full trial would be justified to estimate the effect with greater certainty.
This National Institute of Health Research (NIHR) funded multi-site study included NHS Trusts (Kent and Medway NHS partnership Trust, Oxleas NHS Foundation Trust) and Universities (Queen Mary University, London, Institute of Psychiatry) as partners, and also service user involvement in the research team.
The intervention consists of two elements: a computer-mediated approach in conjunction with non-directive counselling to elicit patient’s perception on their quality of life and care in a medium secure setting. The intervention employs a patient-centred approach making the patient the centre of the conversation, and allowing them to have an active participation in the service provision and research.
Over the past three years, the team have trained staff in six secure mental health units to carry out this new approach and have monitored the monthly meetings between service users and their key nurses, as well as recording a range of clinical, behavioural and social outcomes using quantitative and qualitative approaches. These formal assessments took place prior to the intervention (baseline), at 6 months (post intervention) and at 12 months (follow-up).
It is the first research undertaken in the specialist area of forensic mental health care to examine the active participation of service users in the treatment process, and the findings will influence future work in these clinical areas. The project is now being developed for rolling out the intervention as a national trial.