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Design and protocol for the Focusing on Clozapine Unresponsive Symptoms (FOCUS) trial: a randomised controlled trial

Overview of attention for article published in BMC Psychiatry, August 2016
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Title
Design and protocol for the Focusing on Clozapine Unresponsive Symptoms (FOCUS) trial: a randomised controlled trial
Published in
BMC Psychiatry, August 2016
DOI 10.1186/s12888-016-0983-6
Pubmed ID
Authors

Melissa Pyle, John Norrie, Matthias Schwannauer, David Kingdon, Andrew Gumley, Douglas Turkington, Rory Byrne, Suzy Syrett, Graeme MacLennan, Robert Dudley, Hamish J. McLeod, Helen Griffiths, Samantha Bowe, Thomas R. E. Barnes, Paul French, Paul Hutton, Linda Davies, Anthony P. Morrison

Abstract

For around a third of people with a diagnosis of schizophrenia, the condition proves to respond poorly to treatment with many typical and atypical antipsychotics. This is commonly referred to as treatment-resistant schizophrenia. Clozapine is the only antipsychotic with convincing efficacy for people whose symptoms are considered treatment-resistant to antipsychotic medication. However, 30-40 % of such conditions will have an insufficient response to the drug. Cognitive behavioural therapy has been shown to be an effective treatment for schizophrenia when delivered in combination with antipsychotic medication, with several meta-analyses showing robust support for this approach. However, the evidence for the effectiveness of cognitive behavioural therapy for people with a schizophrenia diagnosis whose symptoms are treatment-resistant to antipsychotic medication is limited. There is a clinical and economic need to evaluate treatments to improve outcomes for people with such conditions. A parallel group, prospective randomised, open, blinded evaluation of outcomes design will be used to compare a standardised cognitive behavioural therapy intervention added to treatment as usual versus treatment as usual alone (the comparator group) for individuals with a diagnosis of schizophrenia for whom an adequate trial of clozapine has either not been possible due to tolerability problems or was not associated with a sufficient therapeutic response. The trial will be conducted across five sites in the United Kingdom. The recruitment target of 485 was achieved, with a final recruitment total of 487. This trial is the largest definitive, pragmatic clinical and cost-effectiveness trial of cognitive behavioural therapy for people with schizophrenia whose symptoms have failed to show an adequate response to clozapine treatment. Using a prognostic risk model, baseline information will be used to explore whether there are identifiable subgroups for which the treatment effect is greatest. Current Controlled Trials ISRCTN99672552 . Registered 29(th) November 2012.

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Mendeley readers

Mendeley readers

The data shown below were compiled from readership statistics for 140 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Chile 1 <1%
United States 1 <1%
Unknown 138 99%

Demographic breakdown

Readers by professional status Count As %
Student > Master 26 19%
Other 16 11%
Student > Ph. D. Student 16 11%
Researcher 13 9%
Student > Bachelor 9 6%
Other 29 21%
Unknown 31 22%
Readers by discipline Count As %
Psychology 38 27%
Medicine and Dentistry 26 19%
Neuroscience 12 9%
Nursing and Health Professions 8 6%
Economics, Econometrics and Finance 4 3%
Other 17 12%
Unknown 35 25%
Attention Score in Context

Attention Score in Context

This research output has an Altmetric Attention Score of 3. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 22 September 2016.
All research outputs
#7,486,175
of 22,881,964 outputs
Outputs from BMC Psychiatry
#2,493
of 4,704 outputs
Outputs of similar age
#129,000
of 366,897 outputs
Outputs of similar age from BMC Psychiatry
#51
of 106 outputs
Altmetric has tracked 22,881,964 research outputs across all sources so far. This one is in the 44th percentile – i.e., 44% of other outputs scored the same or lower than it.
So far Altmetric has tracked 4,704 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 11.9. This one is in the 45th percentile – i.e., 45% of its peers scored the same or lower than it.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 366,897 tracked outputs that were published within six weeks on either side of this one in any source. This one is in the 49th percentile – i.e., 49% of its contemporaries scored the same or lower than it.
We're also able to compare this research output to 106 others from the same source and published within six weeks on either side of this one. This one has gotten more attention than average, scoring higher than 50% of its contemporaries.