New Centre of Excellence to break ground for schizophrenia relapse prevention

Expert psychiatrists from around the world are collaborating on an impressive initiative, known as the Centre of Excellence in Relapse Prevention or "CERP", to fully address the complex field of relapse prevention in patients with psychotic disorders.

Program co-chair Professor Tim Lambert, Professor of Psychological Medicine at Concord Centre for Mental Health and the Brain and Mind Research Institute at Sydney University, said there are so many things experts can be working on for the community.

But he said "we’re just not applying it."

He said, "I would like to quote Professor John Kane (CERP co-chair from Zucker Hillside Hospital, New York) in saying,

‘Given the level of evidence for relapse prevention, the high relapse rates is a public health disgrace.’"

What is "CERP"?

CERP is a forum capitalising on the expertise of both participants and leaders in the psychiatric discipline to examine the most effective methods of incorporating schizophrenia relapse prevention strategies into clinical practice, to benefit the 1 in 100 people affected by the disorder.

The program consists of a series of symposia, held internationally, each by leading clinical experts.

The delegates are engaged at each meeting with interactive presentations and workshops to exchange information and experience on aspects of treating and preventing relapse.

The meetings, usually comprising a group of 10–15 medical professionals, but often overflowing to up to 80 due to popularity, promote interaction with fellow colleagues to provide the utmost collaboration.

Dr Lambert said:

"The first CERP aim focuses on collaboration in education: getting together people who run services, those that want to make a difference and are dedicated to public psychiatry around the world. We can help up-skill them and get them thinking there’s something they can do."

"Further, some centres may want to develop their own expertise and then train their own people to create a regional centre, taking on responsibility in promoting the message."

Though the education program was initially an independent project, it is sponsored by Janssen-Cilag, and supported by some of the most renowned leaders in the field.

The first Australian meeting was held at Concord Hospital (NSW) 14-15 August and was a stunning testament to the capacity of joint research and networking.

"The launch was even more successful than expected. A lot of professionals have gone away to organise and plan their new ideas and to think about becoming sub-centres and setting up education" Professor Lambert said.

"But the most surprising was the feedback, as it was incredibly positive. To summarise, people said it inspired them to do something about this issue, which was exactly our aim.

"That’s why collaboration is so important, because when people work with schizophrenia, they feel they must do everything by themselves, so there is a sense of isolation.

"Some things are frustrating and you can run out of ideas. So we say, ‘Guess what, we’re all in the same boat,’ so we can pool all our ideas to invent new ones."

What calibre of medical professionals are involved?

The international program is co-chaired by Dr Lambert and Dr Kane (from Zucker Hillside Hospital, New York).

Also highly involved are Professor Werner Kissling of the Technical University of Munich, and Professor Eduard Parellada of the Hospital Clinic of Barcelona. All are renowned experts in the field.

Dr Lambert said:

"There needs to be a consistent message. By getting well-known people from around the world, we can show this is not just one person’s idea but that the experts are collaborating."

CERP has been largely driven by Professor Lambert. He aims to provide an opportunity to break new ground for clinical researchers to develop programs around schizophrenia relapse prevention.

What aspects of relapse prevention do the meetings cover?

The meeting program runs for one and a half days and involves interactive activities such as:

• Faculty presentations;
• Practical workshops;
• Group discussions;
• Problem solving sessions; and
• Tour of clinical facilities.

Issues addressed include assessing adherence issues and risk of relapse, practical aspects of administration, clinical techniques, pharmacology, and technologies available to improve adherence, among many others.

Dr Lambert said that with the advent of so many new drugs, it is important to help professionals in administration.

"So we developed a suite of software programs for training people to detect side effects, and we have even redeveloped software to work as a virtual consultant.

"The software is like a distillation of expert opinion on switching medication and measuring outcomes.

"At the meetings, delegates sit with the computers and we do examples with parameters of virtual patients."

How medical professionals can become part of the program

The next Australian meeting will be held 10–11 October at the University of Melbourne. Dr Lambert says it is for those people "really wanting change."

"It is really a matter of reminding doctors there is a lot we can do about relapse prevention; sometimes you have to fight for it."

To get involved and be inspired, email Professor Lambert with your details at tlambert@med.usyd.edu.au