Evaluation of Home Treatment for Acute Psychiatric Care

Not Applicable

• Conditions: Mental Disorder
• Interventions: Other: Treatment-as-usual; Other: Home Treatment

• Registration Number: NCT03320720
• Lead Sponsor: Psychiatric University Hospital, Zurich

Brief Summary

The study's goal is to evaluate whether home treatment is an effective and efficient alternative to inpatient care for people with acute mental illness. Patients who meet the study's inclusion criteria are randomly assigned to either the condition home treatment or inpatient care (treatment-as-usual), during one year. Following two years, the two treatment modalities will be analyzed in terms of inpatient days, cost effectiveness, rehospitalization rate, severity of symptoms and sociodemographics.

Detailed Description

The study's goal is to evaluate whether home treatment is an effective and efficient alternative to inpatient care for people with acute mental illness. Therefore, psychiatric patients in need of hospitalization who meet the study's inclusion criteria are randomly assigned to either the condition home treatment or inpatient care (treatment-as-usual) during one year. Home treatment patients are visited by a mobile and multiprofessional care team at their homes. Additionally, patients without a health insurance for home treatment and patients who are directly assigned to home treatment are included in separate study groups. Following two years, it will be checked whether home treatment leads to a reduction of inpatient days as a primary outcome. Further outcomes such as cost effectiveness, rehospitalization rate, severity of symptoms and sociodemographics will be also analyzed.

Study Timeline

• Status Verified: 2017-10
• Study First Submitted: 2017-10-19
• Study First Submitted QC: 2017-10-24
• Last Update Submitted: 2017-10-24
• Study First Posted: 2017-10-25
• Last Update Posted: 2017-10-25
• Study Start: 2017-11
• Primary Completion: 2020-11
• Study Completion: 2020-11

Recruitment & Eligibility

• Status: UNKNOWN
• Sex: All
• Target Recruitment: 700

Inclusion Criteria

• Need for acute psychiatric inpatient care
• Residence in Zurich city
• Health insurance for Home Treatment

Exclusion Criteria

• none

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
Treatment-as-usual	Treatment-as-usual	Patients with acute mental illness are treated as inpatients in a psychiatric clinic.
Home Treatment	Home Treatment	Patients with acute mental illness are treated at their houses by a mobile and multiprofessional care team instead of being treated as inpatients if their medical condition permits.

Primary Outcome Measures

Name	Time	Method
Inpatient days	2 years follow-up	Number of inpatient days per patient

Secondary Outcome Measures

Name	Time	Method
Total days in treatment	2 years follow-up	Total days in Treatment per patient = inpatient and home treatment
Treatment costs	2 years follow-up	Calculated direct treatment costs
Rehospitalization rate	2 years follow-up	Number of rehospitalizations per patient and duration until rehospitalization
Adverse events	2 years follow-up	e.g. suicide or attempted suicide
Global Assessment of Functioning Scale (GAF)	2 years follow-up	Scale measures social, occupational and psychological functioning and ranges from 0 to 100 (higher values mean better outcome).
Health of the Nation Outcome Scale (HoNOS)	2 years follow-up	Scale measures the severity of symptoms and ranges from 0 to 48 (higher values mean worse outcome).
Clinical Global Impression Scale (CGI)	2 years follow-up	Scale measures the severity of symptoms, global improvement and therapeutic response and ranges from 0 to 7 (higher values mean worse outcome).
Patients' satisfaction	2 years follow-up	Patients' satisfaction assessed by the official questionnaire of the national association of the quality development in hospitals (ANQ)

Trial Locations

Locations (1)

Psychiatric University Hospital Zurich; 🇨🇭 Zürich, Zurich, Switzerland