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Complex intervention in schizophrenia. Results of an integrated care project in German psychiatry and psychotherapy

Published online by Cambridge University Press:  16 April 2020

B. Janssen
Affiliation:
Heinrich-Heine-University, LVR-Klinikum Duesseldorf, Duesseldorf, Germany
C. Schmidt-Kraepelin
Affiliation:
Heinrich-Heine-University, LVR-Klinikum Duesseldorf, Duesseldorf, Germany
W. Gaebel
Affiliation:
Heinrich-Heine-University, LVR-Klinikum Duesseldorf, Duesseldorf, Germany

Abstract

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Introduction

“High utilizing” schizophrenic patients are a problem in routine inpatient care.

Objectives

A complex intervention with improved cooperation between in- and outpatient services was applied to 46 “high utilizing” patients after discharge from inpatient care during an intervention phase of 6 months. The study was controlled by a matched group of 47 patients receiving treatment as usual.

Aims

The goal of this study was to prevent rehospitalizations and thus optimize satisfaction with treatment and quality of life in patients suffering from schizophrenia.

Methods

The intervention was based on a computerized decision support module. Eight psychiatrists in private practices were supplied with this software to obtain guideline-based recommendations according to current psychopathology and clinical state. A local hospital project team arranged specifically suggested interventions. Moderator variables such as socio-demographical aspects or influences of certain interventions to rehospitalization rate were analyzed

Results

Sociodemographical aspects showed no differences between both groups. The rehospitalization rate and the mean length of inpatient treatment were reduced to nearly 50% (Interventiongroup). The rate of readmissions increased in the control group, leading to a difference of 23% between both groups. Cost effectiveness was higher in the interventiongroup than in the controlgroup.

Discussion

The most important single factor was the participation in coping skills training, but only the guideline consistent complex therapies caused the significant overall result. Satisfaction increased during 6 months and remained constant during 12 months of follow up. The project described an important step to gain evidence for integrated care for patients with schizophrenia.

Type
P03-239
Copyright
Copyright © European Psychiatric Association 2011
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