Evidence map›Paper›PMID 27770820›Full record

Trial reportTrials2016

A randomised controlled trial of the clinical and cost-effectiveness of a contingency management intervention compared to treatment as usual for reduction of cannabis use and of relapse in early psychosis (CIRCLE): a study protocol for a randomised controlled trial.

Sonia Johnson, Luke Sheridan Rains, Steven Marwaha, John Strang, Thomas Craig, Tim Weaver, Paul McCrone, Michael King, David Fowler, Stephen Pilling and 4 more

Open access · goldAbstract readComparative StudyRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Trials, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed, 1 pooled it
1.2field-weighted citation impact, top 21% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 1 synthesis or guideline pooled it, 7 citations in OpenAlex.

  1. Pooled it
  2. Trial
  3. Article
  4. Improving outcomes of first-episode psychosis: an overview.World psychiatry : official journal of the World Psychiatric Association (WPA) · 2017
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

14 authors at 5 institutions in 1 country.

Sonia JohnsonDivision of Psychiatry, University College London, London, UK.
Luke Sheridan RainsDivision of Psychiatry, University College London, London, UK. l.sheridanrains@ucl.ac.uk.
Steven MarwahaMental Health and Wellbeing, Warwick Medical School, University of Warwick, Coventry, UK.
John StrangAddictions Department, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, UK.
Thomas CraigHealth Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
Tim WeaverMental Health Social Work & Interprofessional Learning,, Middlesex University London, London, UK.
Paul McCroneDepartment of Health Services and Population Research, King's Health Economics, Institute of Psychiatry, Psychology & Neuroscience, King's College London , London, UK.
Michael KingDivision of Psychiatry, University College London, London, UK.
David FowlerDepartment of Psychology, University of Sussex, Brighton, UK.
Stephen PillingClinical Psychology and Clinical Effectiveness, University College London, London, UK.
Louise MarstonDepartment of Primary Care and Population Health and Priment Clinical Trials Unit, University College London, London, UK.
Rumana Z OmarDepartment of Statistical Science, University College London, London, UK.
Meghan CraigDivision of Psychiatry, University College London, London, UK.
Mark HintonDivision of Psychiatry, University College London, London, UK.
University College London · GBKing's College London · GBMiddlesex University · GBUniversity of Sussex · GBUniversity of Warwick · GB

Funding

Department of Health 09/144/50
6 · The paper itself

Abstract

backgroundAround 35-45 % of people in contact with services for a first episode of psychosis are using cannabis. Cannabis use is associated with delays in remission, poorer clinical outcomes, significant increases in the risk of relapse, and lower engagement in work or education. While there is a clear need for effective interventions, so far only very limited benefits have been achieved from psychological interventions. Contingency management (CM) is a behavioural intervention in which specified desired behavioural change is reinforced through financial rewards. CM is now recognised to have a substantial evidence base in some contexts and its adoption in the UK is advocated by the National Institute for Health and Care Excellence (NICE) guidance as a treatment for substance or alcohol misuse. However, there is currently little published data testing its effectiveness for reducing cannabis use in early psychosis.

methodsCIRCLE is a two-arm, rater-blinded randomised controlled trial (RCT) investigating the clinical and cost-effectiveness of a CM intervention for reducing cannabis use among young people receiving treatment from UK Early Intervention in Psychosis (EIP) services. EIP service users (n = 544) with a recent history of cannabis use will be recruited. The experimental group will receive 12 once-weekly CM sessions, and a voucher reward if urinalysis shows that they have not used cannabis in the previous week. Both the experimental and the control groups will be offered an Optimised Treatment as Usual (OTAU) psychoeducational package targeting cannabis use. Assessment interviews will be performed at consent, at 3 months, and at 18 months. The primary outcome is time to relapse, defined as admission to an acute mental health service. Secondary outcomes include proportion of cannabis-free urine samples during the intervention period, severity of positive psychotic symptoms, quality-adjusted life years, and engagement in work or education. DISCUSSION: CIRCLE is a RCT of CM for cannabis use in young people with a recent history of psychosis (EIP service users) and recent cannabis use. It is designed to investigate whether the intervention is a clinically and cost-effective treatment for cannabis use. It is intended to inform future treatment delivery, particularly in EIP settings.

trial registrationISRCTN33576045 : doi 10.1186/ISRCTN33576045 , registered on 28 November 2011.

Indexed as

Clinical ProtocolsCannabisCost-Benefit AnalysisHumansPsychotic DisordersRecurrenceSample SizeCannabisContingency managementEarly interventionFinancial incentivesPsychosisSubstance misuse

Identifiers

PMID27770820
PMCPMC5075422
OpenAlexW2534797682

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.