Clinical Trial Details
— Status: Enrolling by invitation
Administrative data
| NCT number |
NCT06411951 |
| Other study ID # |
2023-00836 |
| Secondary ID |
|
| Status |
Enrolling by invitation |
| Phase |
|
| First received |
|
| Last updated |
|
| Start date |
June 1, 2023 |
| Est. completion date |
December 31, 2027 |
Study information
| Verified date |
May 2024 |
| Source |
Triaplus AG Klinik Zugersee - Zentrum für Psychiatrie und Psychotherapie |
| Contact |
n/a |
| Is FDA regulated |
No |
| Health authority |
|
| Study type |
Observational
|
Clinical Trial Summary
The study aims to evaluate the treatment effects as well as inhibiting and promoting factors
in the implementation of the new INTUK care offer in a sample of "heavy users", i.e.
psychiatric patients with 4 or more prior inpatient admissions at Klinik Zugersee, by means
of a longitudinal, prospective-retrospective study. For this purpose, medical records will be
analysed and participants will be asked to fill out questionnaires addressing different
aspects of mental health, quality of life and patient satisfaction. In addition,
semi-structured interviews will be conducted with a subset of patients as well as staff
members of the INTUK care offer.
Description:
In the mental health literature, the terms "heavy users" or "high utilizers" have been coined
to describe a relatively small group of people with chronic mental illness, with excess use
of inpatient psychiatric services. Although these terms are used both nationally and
internationally, there is no consensus on how they are defined. For example, in Switzerland,
they are used by the Swiss Health Observatory (Obsan) and the Federal Office of Public
Health. Previous research suggests that even though only 10% to 30% of all inpatients qualify
as "heavy users", their use of the healthcare system's resources is well above average. In
German-speaking countries, there are currently only a few scientific studies on this group of
patients, especially on the question of which offers are best suited to better integrate
existing models of care, and how to make them more effective. Due to the separate enumeration
of outpatient and inpatient care in Switzerland (as in many other countries), integrated
models of care that are particularly needed for this group of patients are currently lacking.
This can result in costly under- and incorrect treatment with more frequent discontinuations.
In addition, apart from the treatment of medical issues, other aspects often play an
important role in the care of chronically ill patients, such as socio-economic difficulties
(e.g. in the areas of work and housing or financial problems). Therefore, in the recently
completed National Research Program (NRP) 74 "Healthcare" of the Swiss National Science
Foundation, the numerous interfaces between care settings were identified as a central field
of action, which is a particularly the case in patients with chronic illnesses: "In the
highly specialized, decentralized health care system in Switzerland, coordination between
multiple medical and non-medical services is difficult."
INTUK (Integrated care after repeated psychiatric hospital stays) represents a new
interprofessional and integrated care program at Klinik Zugersee, which aims to bridge such
interfaces and improve the treatment of people with chronically recurrent mental illness. A
team consisting of a senior physician, nurse, social worker, and peer will deliver
person-centered care tailored to individual needs in these mostly complex care situations.
Contact is initiated with the affected patients during their inpatient stay to build
relationships and increase motivation for subsequent, individually planned treatment and
care. For example, round-table discussions can take place with the specialists and
community-based providers involved in the follow-up treatment before the patient is
discharged. After discharge, the same team continues to provide support and coordinate access
to outpatient and semi-inpatient treatment, counselling and self-help services. In the case
of social difficulties, social work coaching or accompaniment to offices and social
institutions takes place will be provided. Another service is the joint drafting of a
psychiatric living will to determine consent and rejection for future psychiatric treatments.
Wherever possible, close others and the wider social environment are also included in
consultation with the patient.
