Psychoses Clinical Trial
Official title:
Patient-controlled Admissions in Inpatient Mental Health Services
Verified date | January 2021 |
Source | University Hospital, Akershus |
Contact | n/a |
Is FDA regulated | No |
Health authority | |
Study type | Interventional |
Patient-controlled admissions are short self-referred inpatient admissions in mental health services without approval by clinicians. The intention is to reduce a high use of inpatient care. Patients are signing a contract for a specified period with stays limited to a maximum number of days and with a minimum number of weeks between stays. The few studies so far show tendencies to a possible effect, but additional studies are needed. The aims of the study are to describe the use and experiences of patient-controlled admissions, compare the use of inpatient admissions and inpatient days during the 24 months before and after baseline, and to identify subgroups who may benefit from the model. The study is a pre-post prospective intervention study where the use of inpatient admissions in the contract period is compared to a similar period before baseline so that the patients are their own controls. The study is done in inpatient wards in four community mental health centers of Akershus University Hospital, Norway. The study aims to recruit 120 patients. The eligible patients have a severe mental illness, high use of inpatient mental health care the last two years and are expected to benefit from patient-controlled admissions. The patients will be followed for 24 months from baseline. Data at baseline includes socio-demographics, diagnoses, type and severity of psychiatric problems, and use of alcohol and drugs. Data on admissions and experience of these are collected during the contract period, Data on patients' and relatives' experience of the model are collected at the end of the period. Data on total inpatient admissions/stays during the 24 months before and after baseline are extracted from the hospital patient records. Data analyses will include descriptive statistics on the sample and the use of inpatient care, testing of differences of inpatient care between 24 months before and after baseline, multiple regression of associations between baseline characteristics and the use of inpatient care, and analyses to identify subgroups who benefit from the model. The study protocol in Norwegian was approved by the Regional Committee on Medical and Health Research Ethics in Norway South East 29 April 2011 (reg.no. 2011/790). The inclusion period was 2011-2012. Data collection were done 2011-2014. Data extraction from the patient records was done 2015-2016. Quality control and organization of data was done 2017-2018. Data analysis will start in August 2018.
Status | Completed |
Enrollment | 58 |
Est. completion date | December 31, 2012 |
Est. primary completion date | December 31, 2012 |
Accepts healthy volunteers | No |
Gender | All |
Age group | 18 Years and older |
Eligibility | Inclusion Criteria: - Patient with a severe mental illness - Many and/or long inpatient stays in mental health services last two years - Is expected to benefit from a contract about patient-controlled admissions - Have signed a contract about patient-controlled admissions - Give written consent to participate in the study Exclusion Criteria: - No exclusion criteria |
Country | Name | City | State |
---|---|---|---|
n/a |
Lead Sponsor | Collaborator |
---|---|
University Hospital, Akershus |
Heskestad S, Tytlandsvik M. [Patient-guided crisis admissions for severe psychotic conditions]. Tidsskr Nor Laegeforen. 2008 Jan 3;128(1):32-5. Norwegian. — View Citation
Lloyd-Evans B, Slade M, Jagielska D, Johnson S. Residential alternatives to acute psychiatric hospital admission: systematic review. Br J Psychiatry. 2009 Aug;195(2):109-17. doi: 10.1192/bjp.bp.108.058347. Review. — View Citation
Mueser KT, Drake RE, Clark RE, McHugo GJ, Mercer-McFadden C, Ackerson TH. Toolkit for Evaluating Substance Abuse in Person with Severe Mental Illness. 1995.
Nyttingnes O, Šaltyte Benth J, Ruud T. Patient-controlled admission contracts: a longitudinal study of patient evaluations. BMC Health Serv Res. 2021 Jan 7;21(1):36. doi: 10.1186/s12913-020-06033-4. — View Citation
Nyttingnes O, Ruud T. When patients decide the admission - a four year pre-post study of changes in admissions and inpatient days following patient controlled admission contracts. BMC Health Serv Res. 2020 Mar 18;20(1):229. doi: 10.1186/s12913-020-05101-z — View Citation
Støvind H, Hanneborg EM, Ruud T. Bedre tid med brukerstyrte innleggelser? Sykepleien 2012, 100(14):62-64.
Strand M, Gustafsson SA, Bulik CM, von Hausswolff-Juhlin Y. Patient-controlled hospital admission: A novel concept in the treatment of severe eating disorders. Int J Eat Disord. 2015 Nov;48(7):842-4. doi: 10.1002/eat.22445. Epub 2015 Aug 28. — View Citation
Thomsen CT, Benros ME, Maltesen T, Hastrup LH, Andersen PK, Giacco D, Nordentoft M. Patient-controlled hospital admission for patients with severe mental disorders: a nationwide prospective multicentre study. Acta Psychiatr Scand. 2018 Apr;137(4):355-363. doi: 10.1111/acps.12868. Epub 2018 Mar 4. — View Citation
Wills CE, Holmes-Rovner M. Integrating Decision Making and Mental Health Interventions Research: Research Directions. Clin Psychol (New York). 2006;13(1):9-25. — View Citation
Wing JK, Beevor AS, Curtis RH, Park SB, Hadden S, Burns A. Health of the Nation Outcome Scales (HoNOS). Research and development. Br J Psychiatry. 1998 Jan;172:11-8. — View Citation
Type | Measure | Description | Time frame | Safety issue |
---|---|---|---|---|
Primary | Number of inpatient days during the 24 months period with a contract for patient-controlled admissions compared to the previous 24 months | Number of inpatient days during the 24 months period with a contract for patient-controlled admissions compared to the previous 24 months | 24 months | |
Secondary | Number of inpatient admissions during the 24 months period with a contract about patient-controlled admissions compared to the previous 24 months | Number of inpatient admissions during the 24 months period with a contract about patient-controlled admissions compared to the previous 24 months | 24 months | |
Secondary | Number of involuntary inpatient admissions during the 24 months period with a contract about patient-controlled admissions compared to the previous 24 months | Number of involuntary inpatient admissions during the 24 months period with a contract about patient-controlled admissions compared to the previous 24 months | 24 months | |
Secondary | Number of inpatient days under coercion during the 24 months period with a contract about patient-controlled admissions compared to the previous 24 months | Number of inpatient days under coercion during the 24 months period with a contract about patient-controlled admissions compared to the previous 24 months | 24 months | |
Secondary | Patients' experience of patient-controlled admissions as reported at the end of the stay | Questions on experience are listed in the questionnaire/interview to be completed at the end of each patient-controlled admission/stay. | 24 months | |
Secondary | Patients' experience of patient-controlled admissions as reported at the end of the period with contract about patient-controlled admissions | Questions on experience are listed in the questionnaire/interview to be completed at the end of the period with contract about patient-controlled admissions | 24 months | |
Secondary | Relatives' experience of patient-controlled admissions as reported at the end of the period with contract about patient-controlled admissions | Questions on experience are listed in the questionnaire/interview to be completed at the end of the period with contract about patient-controlled admissions | 24 months |
Status | Clinical Trial | Phase | |
---|---|---|---|
Completed |
NCT01196858 -
Duration of Untreated Psychosis (DUP) and Pathways to Care in Nordland
|
N/A | |
Completed |
NCT00070889 -
Brain Cell Injury in Patients With A First Episode of Psychosis
|
N/A | |
Completed |
NCT00159120 -
Maintenance Treatment vs. Stepwise Drug Discontinuation in First-Episode Schizophrenia
|
Phase 4 | |
Completed |
NCT00159133 -
Prodrome-Based Early Intervention With Antipsychotics vs. Benzodiazepines in First-Episode Schizophrenia
|
Phase 4 | |
Completed |
NCT00087542 -
Treatment of Hallucinosis/Psychosis in Parkinson's Disease by an Investigational Drug
|
Phase 2 | |
Completed |
NCT00095810 -
Aripiprazole in Patients With Psychosis Associated With Parkinson's Disease
|
Phase 4 | |
Recruiting |
NCT00752960 -
DNA Diagnostics for Minimizing Metabolic Side-Effects of Antipsychotics
|
N/A | |
Completed |
NCT00469365 -
Pharmacy Interventions to Improve Chronic Disease Medication Refill
|
Phase 3 | |
Completed |
NCT00491569 -
Sarcosine or D-Serine Add-on Treatment for Chronic Schizophrenia
|
Phase 2 | |
Completed |
NCT00204061 -
Early Pharmacological and Psychological Intervention for Late Prodromal States of Psychosis
|
Phase 4 | |
Completed |
NCT00328276 -
Sarcosine (N-Methylglycine) Monotherapy for Schizophrenia
|
Phase 2 | |
Withdrawn |
NCT00276263 -
Sarcosine Preventive Therapy for Individuals At High Risk for Schizophrenia
|
Phase 2 | |
Active, not recruiting |
NCT00260273 -
Access, Detection and Psychological Treatments
|
N/A | |
Completed |
NCT00960219 -
D-amino Acid Oxidase Inhibition (DAAOI-1) add-on Treatment for Chronic Schizophrenia
|
Phase 2 |