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Four-year outcome in non-compliant schizophrenia patients treated with or without home-based ambulatory outpatient care

Published online by Cambridge University Press:  16 April 2020

O. Kampman ,
A. Illi ,
P. Poutanen  and
E. Leinonen
O. Kampman*
Affiliation:
University of Tampere, Medical School, 33014, Finland Tampere Community Mental Health Care, Finland
A. Illi
Affiliation:
Department of Psychiatry, Tampere University Hospital, Finland
P. Poutanen
Affiliation:
Department of Psychiatry, Tampere University Hospital, Finland
E. Leinonen
Affiliation:
University of Tampere, Medical School, 33014, Finland Department of Psychiatry, Tampere University Hospital, Finland
*
*E-mail address: olli.kampman@uta.fi
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Abstract

Non-compliance in neuroleptic maintenance treatment is a major concern in schizophrenia. Home-based outpatient care has been shown both to improve medication compliance and reduce relapse frequency. We analysed the need for hospitalisation, levels of functioning and mortality rate during the de-institutionalisation process in 41 schizophrenia patients with repeated hospitalisations and prolonged history of non-compliance. Eighteen of the patients received ambulatory outpatient care (AOC) after discharge. This treatment procedure focuses on enduring neuroleptic maintenance treatment. One of the hospital nurses takes care of home visits every 2–4 weeks. In the 4-year follow-up, half of the patients in the AOC group did not need hospitalisation at all and the number of days of hospitalisation in the whole group diminished by almost four-fifths compared with the previous 4 years. In the non-AOC group, there was a more limited decrease in the number of days of hospitalisation during the corresponding follow-up period. The mortality rates showed a slight tendency towards a better outcome in the AOC group. There was no change in the levels of functioning in the AOC group. This treatment can be carried out with limited resources. It clearly reduces the need for hospitalisation in a subgroup of schizophrenia patients having problems with compliance and recurrent relapse. The effectiveness of AOC on the mortality rates of schizophrenia patients needs further examination.

Keywords

SchizophreniaComplianceRelapseAmbulatory careMortality
Type
Original article
Information
European Psychiatry , Volume 18 , Issue 1 , February 2003 , pp. 1 - 5
Copyright
Copyright © Éditions scientifiques et médicales Elsevier SAS 2002

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References

Amador, XF, Strauss, DH, Yale, SA, Gorman, JMAwareness of illness in schizophrenia. Schizophr Bull 1991;17:113–32.CrossRefGoogle Scholar
Bazire, SPsychotropic Drug Directory. Dinton, Nr Salisbury: Mark Allen Publishing; 2000.Google Scholar
Brown, SExcess mortality of schizophrenia. A meta-analysis. Br J Psychiatry 1997;171:502–8.CrossRefGoogle ScholarPubMed
Casper, ES, Regan, JRReasons for admission among six profile subgroups of recidivists of inpatient services. Can J Psychiatry 1993;38:657–61.CrossRefGoogle ScholarPubMed
Cuffel, BJ, Alford, J, Fischer, EP, Owen, RRAwareness of illness in schizophrenia and outpatient treatment adherence. J Nerv Ment Dis-ord 1996;184:653–9.CrossRefGoogle ScholarPubMed
Davis, JM, Kane, JM, Marder, SR, Brauzer, B, Gierl, B, Schooler, Net al. Dose response of prophylactic antipsychotics. J Clin Psychiatry 1993;54(Suppl.):24–30.Google ScholarPubMed
Drake, RE, Osher, FC, Wallach, MAAlcohol use and abuse in schizophrenia. A prospective community study. J Nerv Ment Disord 1989;177:408–14.CrossRefGoogle ScholarPubMed
Fenton, WS, Blyler, CR, Heinssen, RKDeterminants of medication compliance in schizophrenia: empirical and clinical findings. Schizophr Bull 1997;23:637–51.CrossRefGoogle ScholarPubMed
Gerlach, JOral versus depot administration of neuroleptics in relapse prevention. Acta Psychiatry Scand 1994;89:28–32.CrossRefGoogle Scholar
Hambridge, JA, Rosen, AAssertive community treatment for the seriously mentally ill in suburban Sydney – a programme description and evaluation. Austr NZ J Psychiatry 1994;28:438–45.CrossRefGoogle Scholar
Honkonen, T, Saarinen, S, Salokangas, RKDeinstitutionalization and schizophrenia in Finland II: discharged patients and their psychosocial functioning. Schizophr Bull 1999;25:543–51.CrossRefGoogle ScholarPubMed
Joukamaa, M, Heliövaara, M, Knekt, P, Aromaa, A, Raitasalo, R, Lehtinen, VMental disorders and cause-specific mortality. Br J Psychiatry 2001;179:498–502.CrossRefGoogle ScholarPubMed
Kaltiala-Heino, R, Laippala, P, Joukamaa, MHas the attempt to reduce psychiatric inpatient treatment been successful in Finland? Eur Psychiatry 2001;16:215–21.CrossRefGoogle ScholarPubMed
Kane, JM. Compliance issues in outpatient treatment. J Clin Psychop-harmacol 1985;5(Suppl. 3):22–7.CrossRefGoogle ScholarPubMed
Kent, S, Yellowlees, PPsychiatric and social reasons for frequent rehospitalization. Hosp Commun Psychiatry 1994;45:347–50.Google ScholarPubMed
Lelliott, P, Wing, J, Clifford, PA national audit of new long-stay psychiatric patients 1. Method and description of the cohort. Br J Psychiatry 1994;165:160–9.Google Scholar
Marshall, M, Lockwood, AAssertive community treatment for people with severe mental disorders. Cochr Datab Sys Rev 2001;1.Google ScholarPubMed
Morrison, DP. Management of treatment refractory schizophrenia. Br J Psychiatry Dec 1996;169(Suppl. 31):15–20.CrossRefGoogle Scholar
National Agency for Welfare and Health. Census of patients in psychiatric wards 1984–1991. Helsinki: Government printing center; 1992.Google Scholar
Rasanen, S, Hakko, H, Herva, A, Isohanni, M, Nieminen, P, Moring, JCommunity placement of long-stay psychiatric patients in northern Finland. Psychiatry Serv 2000;51:383–5.Google ScholarPubMed
Santos, AB, Deci, PA, Lachance, KR, Dias, JK, Sloop, TB, Hiers, TGet al. Providing assertive community treatment for severely mentally ill patients in a rural area. Hosp Commun Psychiatry 1993;44:34–9.Google Scholar
Seltzer, A, Roncari, I, Garfinkel, PEffect of patient education on medication compliance. Can J Psychiatry 1980;25:638–45.CrossRefGoogle ScholarPubMed
Taube, CA, Morlock, L, Burns, BJ, Santos, ABNew directions in research on assertive community treatment. Hosp Commun Psychiatry 1990;41:642–7.Google ScholarPubMed
Van-Putten, T, Crumpton, E, Yale, CDrug refusal in schizophrenia and the wish to be crazy. Arch Gen Psychiatry 1976;33:1443–6.CrossRefGoogle ScholarPubMed
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