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Clinical and functional outcome of assertive outreach for patients with schizophrenic disorder: Results of a quasi-experimental controlled trial


Kästner, D; Büchtemann, D; Warnke, I; Radisch, J; Baumgardt, J; Giersberg, S; Kopke, K; Moock, J; Kawohl, W; Rössler, W (2015). Clinical and functional outcome of assertive outreach for patients with schizophrenic disorder: Results of a quasi-experimental controlled trial. European Psychiatry, 30(6):736-742.

Abstract

BACKGROUND: The majority of studies support modern assertive health service models. However, the evidence is limited for parts of continental Europe, as well as for the pharmacological adherence outcome parameter.
METHOD: We conducted a quasi-experimental controlled trial including adult patients with a schizophreniform disorder and a maximum of 60 points on the Global Assessment of Functioning Scale (GAF). Interventions (n=176) and controls (TAU, n=142) were assessed every six-month within one year in 17 study practices in rural areas. Mental and functional state were rated using the Brief Psychiatric Rating Scale (BPRS) and the GAF. Functional limitations and pharmacological adherence were patient-rated using the WHO-Disability Assessment Schedule II (WHODAS-II) and the Medication Adherence Report Scale (MARS). We computed multilevel mixed models.
RESULTS: The GAF and BPRS of both groups improved significantly, yet the increase in the intervention group was significantly higher. In contrast, patient-rated variables - WHODAS-II and MARS - neither showed a stable temporal improvement nor a difference between groups.
CONCLUSION: Our findings only partly support the investigated AO intervention, because of conflicting results between clinician- and patient-ratings. Accordingly, the benefits of AO need to be further evaluated.

Abstract

BACKGROUND: The majority of studies support modern assertive health service models. However, the evidence is limited for parts of continental Europe, as well as for the pharmacological adherence outcome parameter.
METHOD: We conducted a quasi-experimental controlled trial including adult patients with a schizophreniform disorder and a maximum of 60 points on the Global Assessment of Functioning Scale (GAF). Interventions (n=176) and controls (TAU, n=142) were assessed every six-month within one year in 17 study practices in rural areas. Mental and functional state were rated using the Brief Psychiatric Rating Scale (BPRS) and the GAF. Functional limitations and pharmacological adherence were patient-rated using the WHO-Disability Assessment Schedule II (WHODAS-II) and the Medication Adherence Report Scale (MARS). We computed multilevel mixed models.
RESULTS: The GAF and BPRS of both groups improved significantly, yet the increase in the intervention group was significantly higher. In contrast, patient-rated variables - WHODAS-II and MARS - neither showed a stable temporal improvement nor a difference between groups.
CONCLUSION: Our findings only partly support the investigated AO intervention, because of conflicting results between clinician- and patient-ratings. Accordingly, the benefits of AO need to be further evaluated.

Citations

1 citation in Web of Science®
1 citation in Scopus®
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Additional indexing

Item Type:Journal Article, refereed, original work
Communities & Collections:04 Faculty of Medicine > Psychiatric University Hospital Zurich > Clinic for Psychiatry, Psychotherapy, and Psychosomatics
Dewey Decimal Classification:610 Medicine & health
Language:English
Date:September 2015
Deposited On:18 Jan 2016 16:41
Last Modified:05 Apr 2016 19:53
Publisher:Elsevier
ISSN:0924-9338
Publisher DOI:https://doi.org/10.1016/j.eurpsy.2015.04.003
PubMed ID:26003931

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