Evaluation of Home Treatment for Acute Psychiatric Care

Evaluation of Home Treatment for Acute Psychiatric Care of the Psychiatric University Hospital Zurich (Switzerland)

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.

Study Overview

• Status: Unknown
• Conditions: Mental Disorder
• Intervention / Treatment: Other: Home Treatment; Other: Treatment-as-usual

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 Type: Interventional
• Enrollment (Anticipated): 700
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Switzerland
  • Zurich
    • Zürich, Zurich, Switzerland, 8032
      • Psychiatric University Hospital Zurich

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years to 65 years (Adult, Older Adult)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

Description

Inclusion Criteria:

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

Exclusion Criteria:

• none

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Health Services Research
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: None (Open Label)

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: 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.	Other: Home Treatment; Patients with acute mental illness in need of inpatient care are treated at their houses by a mobile and multiprofessional care team if their health condition permits.
Active Comparator: Treatment-as-usual; Patients with acute mental illness are treated as inpatients in a psychiatric clinic.	Other: Treatment-as-usual; Patients with acute mental illness in need of inpatient care are treated in a psychiatric clinic.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Inpatient days	Number of inpatient days per patient	2 years follow-up

Secondary Outcome Measures

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

Collaborators and Investigators

• Sponsor: Psychiatric University Hospital, Zurich
• Investigators: Principal Investigator: Matthias Jäger, MD, Psychiatric University Hospital, Zurich

Study record dates

Study Major Dates

• Study Start (Anticipated): November 1, 2017
• Primary Completion (Anticipated): November 1, 2020
• Study Completion (Anticipated): November 1, 2020

Study Registration Dates

• First Submitted: October 19, 2017
• First Submitted That Met QC Criteria: October 24, 2017
• First Posted (Actual): October 25, 2017

Study Record Updates

• Last Update Posted (Actual): October 25, 2017
• Last Update Submitted That Met QC Criteria: October 24, 2017
• Last Verified: October 1, 2017

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Mental Disorders
• Other Study ID Numbers: HT201701349

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: No

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No