Home Treatment for Acute Psychiatric Care

Mental Disorders Clinical Trial

Official title:

Home Treatment for Acute Psychiatric Care in the Canton of Aargau (Switzerland): A Randomized Controlled Trial

Clinical Trial Details — Status: Completed

Administrative data

• NCT number: NCT02322437
• Other study ID #: PDAG-0001
• Status: Completed
• Phase: N/A
• Start date: April 2015
• Est. completion date: April 2018

Study information

• Verified date: June 2018
• Source: Psychiatric Services Aargau AG
• Contact: n/a
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial Summary

This study aims to evaluate whether psychiatric home treatment is an effective and efficient alternative to acute inpatient care in mental hospitals. A one-year prevalence cohort of psychiatric patients in need of hospitalization are randomly assigned to either treatment at inpatient wards (treatment as usual) or a new care model with the additional option of treating patients at their homes by mobile care teams. The primary focus is on checking whether optional home treatment leads to a reduction of inpatient days during a two-year follow-up period. In addition, the two service models will be compared regarding treatment cost and outcomes as well as satisfaction of patients and their relatives with psychiatric care.

Furthermore, a sub-cohort of randomly chosen patients from the prevalence-cohort will be examined by a highly trained clinical assessor to test and verify the diagnoses and the clinical ratings made by the staff members of the mental hospital under routine everyday conditions.

Description:

This study aims to evaluate whether psychiatric home treatment is an effective and efficient alternative to acute inpatient care in mental hospitals. A one-year prevalence cohort of psychiatric patients in need of hospitalization are randomly assigned to either treatment at inpatient wards (treatment as usual) or a new care model with the additional option of treating patients at their homes by mobile care teams. The primary focus is on checking whether optional home treatment for crisis intervention leads to a reduction of inpatient days during a two-year follow-up period. In addition, the two service models will be compared regarding treatment cost and outcomes as well as satisfaction of patients and their relatives with psychiatric care.

Furthermore, a sub-cohort of randomly chosen patients from the prevalence-cohort will be examined by a highly trained clinical assessor to test and verify the diagnoses (SCID-I and SCID-II) and the clinical ratings (HoNOS) made by the staff members of the mental hospital under routine everyday conditions.

Recruitment information / eligibility

• Status: Completed
• Enrollment: 707
• Est. completion date: April 2018
• Est. primary completion date: April 2018
• Accepts healthy volunteers: No
• Gender: All
• Age group: 18 Years to 64 Years

Eligibility

Inclusion Criteria:

• Need for acute psychiatric inpatient care

• Residence in the canton of Aargau

• Living within 30 minutes (by car) from the headquarters of the home treatment team

• Health insurance with tarifsuisse

Exclusion Criteria:

• Insufficient proficiency in German

• Main diagnosis F0 or F1 (ICD-10)

• Patients of the forencic departement

• Patients of the child and adolescent department

Related Conditions & MeSH terms

• Mental Disorders
• Psychotic Disorders

Intervention

Other:
• Home treatment
Patients are treated at home whenever possible and appropriate
• Treatment As Usual
Patients are treated at a mental hospital

Locations

Country	Name	City	State
Switzerland	Psychiatric Services Aargau AG	Brugg	Aargau

Sponsors (2)

Lead Sponsor	Collaborator
Psychiatric Services Aargau AG	Hugo & Elsa Isler Foundation

Country where clinical trial is conducted

Switzerland, 

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Number of inpatient days		2 years follow-up
Secondary	Total days in treatment (inpatient + home treatment)		2 years follow-up
Secondary	Direct treatment costs		2 years follow-up
Secondary	Health of the Nation Outcome Scales (HoNOS)	Participants will be followed for the duration of hospital stay, an expected average of 4 weeks.	Intake and discharge from treatment episode (expected average of 4 weeks)
Secondary	Brief Symptom Checklist (BSCL)	Participants will be followed for the duration of hospital stay, an expected average of 4 weeks.	Intake and discharge from treatment episode (expected average of 4 weeks)
Secondary	Perceptions of Care-18	Participants will be assessed at discharge from hospital, after an expected average of 4 weeks.	Discharge from treatment episode (expected average of 4 weeks)
Secondary	Satisfaction of patients' relatives	Relatives' satisfaction will be assessed with an adapted version of the Perceptions of Care-18 questionnaire at discharge of the patients from hospital, after an expected average of 4 weeks. The proportion of satisfied relatives will be reported for both study arms.	Discharge from treatment episode (expected average of 4 weeks)
Secondary	Number of rehospitalizations per patient		2 years follow-up
Secondary	Number of patients with adverse events	E.g. suicide or attempted suicide.	2 years follow-up