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• W2917362984 abstract "Background Clozapine (clozaril, Mylan Products Ltd) is a first-choice treatment for people with schizophrenia who have a poor response to standard antipsychotic medication. However, a significant number of patients who trial clozapine have an inadequate response and experience persistent symptoms, called clozapine-resistant schizophrenia (CRS). There is little evidence regarding the clinical effectiveness of pharmacological or psychological interventions for this population. Objectives To evaluate the clinical effectiveness and cost-effectiveness of cognitive–behavioural therapy (CBT) for people with CRS and to identify factors predicting outcome. Design The Focusing on Clozapine Unresponsive Symptoms (FOCUS) trial was a parallel-group, randomised, outcome-blinded evaluation trial. Randomisation was undertaken using permuted blocks of random size via a web-based platform. Data were analysed on an intention-to-treat (ITT) basis, using random-effects regression adjusted for site, age, sex and baseline symptoms. Cost-effectiveness analyses were carried out to determine whether or not CBT was associated with a greater number of quality-adjusted life-years (QALYs) and higher costs than treatment as usual (TAU). Setting Secondary care mental health services in five cities in the UK. Participants People with CRS aged ≥ 16 years, with an International Classification of Diseases , Tenth Revision (ICD-10) schizophrenia spectrum diagnoses and who are experiencing psychotic symptoms. Interventions Individual CBT included up to 30 hours of therapy delivered over 9 months. The comparator was TAU, which included care co-ordination from secondary care mental health services. Main outcome measures The primary outcome was the Positive and Negative Syndrome Scale (PANSS) total score at 21 months and the primary secondary outcome was PANSS total score at the end of treatment (9 months post randomisation). The health benefit measure for the economic evaluation was the QALY, estimated from the EuroQol-5 Dimensions, five-level version (EQ-5D-5L), health status measure. Service use was measured to estimate costs. Results Participants were allocated to CBT ( n = 242) or TAU ( n = 245). There was no significant difference between groups on the prespecified primary outcome [PANSS total score at 21 months was 0.89 points lower in the CBT arm than in the TAU arm, 95% confidence interval (CI) –3.32 to 1.55 points; p = 0.475], although PANSS total score at the end of treatment (9 months) was significantly lower in the CBT arm (–2.40 points, 95% CI –4.79 to –0.02 points; p = 0.049). CBT was associated with a net cost of £5378 (95% CI –£13,010 to £23,766) and a net QALY gain of 0.052 (95% CI 0.003 to 0.103 QALYs) compared with TAU. The cost-effectiveness acceptability analysis indicated a low likelihood that CBT was cost-effective, in the primary and sensitivity analyses (probability < 50%). In the CBT arm, 107 participants reported at least one adverse event (AE), whereas 104 participants in the TAU arm reported at least one AE (odds ratio 1.09, 95% CI 0.81 to 1.46; p = 0.58). Conclusions Cognitive–behavioural therapy for CRS was not superior to TAU on the primary outcome of total PANSS symptoms at 21 months, but was superior on total PANSS symptoms at 9 months (end of treatment). CBT was not found to be cost-effective in comparison with TAU. There was no suggestion that the addition of CBT to TAU caused adverse effects. Future work could investigate whether or not specific therapeutic techniques of CBT have value for some CRS individuals, how to identify those who may benefit and how to ensure that effects on symptoms can be sustained. Trial registration Current Controlled Trials ISRCTN99672552. Funding This project was funded by the National Institute for Health Research (NIHR) Health Technology Assessment programme and will be published in full in Health Technology Assessment ; Vol. 23, No. 7. See the NIHR Journals Library website for further project information." @default.
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• W2917362984 date "2019-02-01" @default.
• W2917362984 modified "2023-10-18" @default.
• W2917362984 title "Cognitive–behavioural therapy for clozapine-resistant schizophrenia: the FOCUS RCT" @default.
• W2917362984 cites W102833839 @default.
• W2917362984 cites W1498823917 @default.
• W2917362984 cites W1502944888 @default.
• W2917362984 cites W1595379164 @default.
• W2917362984 cites W164302377 @default.
• W2917362984 cites W166560170 @default.
• W2917362984 cites W1826521770 @default.
• W2917362984 cites W1828019950 @default.
• W2917362984 cites W1835966027 @default.
• W2917362984 cites W1953022957 @default.
• W2917362984 cites W1964438525 @default.
• W2917362984 cites W1966020199 @default.
• W2917362984 cites W1967680634 @default.
• W2917362984 cites W1971997734 @default.
• W2917362984 cites W1975560743 @default.
• W2917362984 cites W1976741101 @default.
• W2917362984 cites W1977053386 @default.
• W2917362984 cites W1980699947 @default.
• W2917362984 cites W1981674452 @default.
• W2917362984 cites W1981722146 @default.
• W2917362984 cites W1982540987 @default.
• W2917362984 cites W1982900907 @default.
• W2917362984 cites W1983722797 @default.
• W2917362984 cites W1986578262 @default.
• W2917362984 cites W1988265553 @default.
• W2917362984 cites W1989187405 @default.
• W2917362984 cites W1989904540 @default.
• W2917362984 cites W1992857340 @default.
• W2917362984 cites W1995330287 @default.
• W2917362984 cites W1995380902 @default.
• W2917362984 cites W2000581275 @default.
• W2917362984 cites W2010913334 @default.
• W2917362984 cites W2013564592 @default.
• W2917362984 cites W2016959000 @default.
• W2917362984 cites W2018317330 @default.
• W2917362984 cites W2021747099 @default.
• W2917362984 cites W2022387798 @default.
• W2917362984 cites W2022481935 @default.
• W2917362984 cites W2022787364 @default.
• W2917362984 cites W2025374085 @default.
• W2917362984 cites W2026791659 @default.
• W2917362984 cites W2029211952 @default.
• W2917362984 cites W2031192891 @default.
• W2917362984 cites W2036480935 @default.
• W2917362984 cites W2039142202 @default.
• W2917362984 cites W2039952445 @default.
• W2917362984 cites W2041224506 @default.
• W2917362984 cites W2047073785 @default.
• W2917362984 cites W2047748467 @default.
• W2917362984 cites W2049907076 @default.
• W2917362984 cites W2054583263 @default.
• W2917362984 cites W2059329387 @default.
• W2917362984 cites W2061304590 @default.
• W2917362984 cites W2061410297 @default.
• W2917362984 cites W2065386111 @default.
• W2917362984 cites W2065530821 @default.
• W2917362984 cites W2065729150 @default.
• W2917362984 cites W2066357241 @default.
• W2917362984 cites W2066477175 @default.
• W2917362984 cites W2070461647 @default.
• W2917362984 cites W2075393761 @default.
• W2917362984 cites W2078394222 @default.
• W2917362984 cites W2078401005 @default.
• W2917362984 cites W2082235434 @default.
• W2917362984 cites W2085360366 @default.
• W2917362984 cites W2085488608 @default.
• W2917362984 cites W2089165963 @default.
• W2917362984 cites W2089868642 @default.
• W2917362984 cites W2090975743 @default.
• W2917362984 cites W2093919362 @default.
• W2917362984 cites W2094750049 @default.

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