Can computer-assisted cognitive remediation improve employment and productivity outcomes of patients with severe mental illness? A meta-analysis of prospective controlled trials
Nine prospective controlled trials were identified from 2005 to 2014 in United States, Germany, Italy, Singapore and Japan.
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Patients receiving CACR had significantly higher employment rate than those without CACR (41% vs 24%, RD = 20%).
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Patients receiving CACR worked significantly longer than those without CACR (MD = 19.5 days).
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Patients receiving CACR earned significantly higher wages than those without CACR (MD = US$959).
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CACR was recommended to incorporate into regular vocational rehabilitation programmes.
Abstract
Background
Computer-assisted cognitive remediation (CACR) has been demonstrated to enhance cognition of patients with severe mental illness (SMI). Patients with improved cognitive skills may find it easier to be employed, and the ability to maintain employment is an important sign of recovery.
Aim
To assess whether CACR is an effective method to enhance work-related outcomes in patients with SMI.
Method
Prospective controlled trials evaluating CACR on productivity outcomes were systematically identified from the OVID databases. Employment rates, total days of work in a year, and total annual earnings were defined as the productivity outcomes.
Results
Nine trials were published between 2005 and 2014 and were conducted in the United States, Germany, Italy, Singapore and Japan. A total of 740 patients with mean age of 36.4 years were included. The duration of CACR ranged from 2 months to 2 years, and the patients were followed-up from 1 year to 3 years. Patients receiving CACR showed 20% higher employment rate (95% CI = 5%–35%), worked 19.5 days longer in a year (95% CI = 2.5–36.6 days), and earned US$959 more in total annual earnings (95% CI = US$285 to US$1634) than those not receiving CACR.
Conclusion
CACR can enhance productivity outcomes for patients with SMI, including higher employment rate, longer duration of work and higher income. The economic benefit of CACR can enhance the quality of life for patients with SMI, and may reduce financial burden on the health and welfare system. Therefore, CACR can be recommended and incorporated into regular vocational rehabilitation programs.
