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What is the EXTEND study?

The EXTEND study is a multi-centre research project involving academic, clinical, and PPI partners across the University of Oxford, Manchester Metropolitan University, Cardiff University, Imperial College London, Keele University, and Pennine Care NHS Foundation Trust. The study is funded by an NIHR Programme Grant for Applied Research (reference number: NIHR203277). The aim of the project is to explore the impact of duration of treatment in Early Intervention in Psychosis (EIP) services on outcomes for individuals experiencing their first episode of psychosis (FEP).

Why are we undertaking this project?

EIP services are phase-specific community mental health teams that treat people with FEP. Currently, EIP services are time-limited to 3 years, the rationale being that early intensive treatment will preclude the need for ongoing care (a secondary prevention approach).

It is not known what the optimal length of EIP treatment should be. People with FEP can have diverse illness trajectories, meaning an eventual outcome is not easy to predict. Some people may benefit from longer treatment. Alternatively, delivery of specific treatments may be more important than the overall duration of EIP, which could therefore be delivered in a shorter timeframe. The aim of the EXTEND study is to determine whether a flexible, needs-focussed EIP treatment could be used as an alternative to the current time-limited service.

What does the study involve?

The EXTEND project will leverage current variation in the delivery of EIP to explore whether this variation results in different outcomes. The study objectives will be delivered through four work packages (WP):

  • To understand current EIP provision by examining service-user experiences and using linked (anonymised) national datasets (WP1).
  • To investigate the impact of the duration of EIP treatment on health outcomes by examining detailed case-studies and using national datasets to estimate the causal effect of duration of EIP treatment and (WP2).
  • To estimate the cost-effectiveness of flexible, needs assessed EIP services using economic models applied to national datasets (WP3).
  • To develop evidence-based guidance to guide clinical decision making and commissioning (WP4).