4.2 Chinese studies versus full analysis
We also compared primary outcomes of Chinese studies with primary
outcomes of the full analysis (full analysis = Chinese studies
+ non-Chinese studies) and found no clear differences. For example,
non-compliance rate of Chinese studies was 0.85 CI 0.48 to
1.51 (n = 346) and that of all studies 1.00 CI 0.79 to 1.26 (n =
949). The same applies to the outcome of relapse (Chinese studies
n = 700, RR 0.48 CI 0.35 to 0.66; all studies n = 1214 RR 0.7 CI
0.61 to 0.81). Please see Table 1 for details.
4.3 English studies versus full analysis
We performed similar sensitivity analysis for non-Chinese trials(
i.e. trials of any other language) and found no significant difference.
Please refer to Table 2 for details.
D I S C U S S I O N
Summary of main results
Comparison 1. Any form of psychoeducation versus
standard care
(Summary of findings for the main comparison)
1.1 Compliance
This was a primary outcome of this review. Overall, psychoeducation
promoted considerably better compliance with medication
compared with standard care. This was recorded over different
time periods and by different means, but the finding seems to be a
consistently favouring the psychoeducation group. Even with the
risk of overestimation of effect (Juni 2001) there may be some
residual evidence that a psychoeducation approach does help people
towards taking medication on a more regular basis. Numbers
needed to treat are relatively small, and, although they may inflate
in everyday care, where the skill of the psychoeducation therapist
may not be as great as was seen in these trials, the effort expended
to gain increased medication compliance may be seen as acceptable.
Where it comes to loss to follow-up or leaving the study early,
there is no evidence that either treatment is less acceptable than
the other. About 25% of people left early in both groups. For the
outcome of ‘allocated but never accepted treatment’ (Analysis 1.6)
more people in the psychoeducation group were not compliant (2
RCTs, n = 213, RR 12.27 CI 2.58 to 58.33, NNT 9 CI 64 to 2)
but we are unsure if this outcome was available to the standard
care group.