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RCT on discharge planning for high utilisers of psychiatric services I: Background and first results

Published online by Cambridge University Press:  16 April 2020

B. Puschner
Affiliation:
Department of Psychiatry II, Ulm University, Günzburg, Germany
W. Gaebel
Affiliation:
Department of Psychiatry and Psychotherapy, Düsseldorf University, Düsseldorf, Germany
B. Janssen
Affiliation:
Department of Psychiatry and Psychotherapy, Düsseldorf University, Düsseldorf, Germany
M. Ramacher
Affiliation:
Department of Psychiatry and Psychotherapy, Düsseldorf University, Düsseldorf, Germany
H.E. Klein
Affiliation:
Department of Psychiatry and Psychotherapy, Greifswald University, Stralsund, Germany
C. Cording
Affiliation:
Department of Psychiatry and Psychotherapy, Greifswald University, Stralsund, Germany
H. Spießl
Affiliation:
Department of Psychiatry and Psychotherapy, Greifswald University, Stralsund, Germany
K. Sohla
Affiliation:
Department of Psychiatry and Psychotherapy, Greifswald University, Stralsund, Germany
H. Freyberger
Affiliation:
Department of Psychiatry and Psychotherapy, Regensburg University, Regensburg, Germany
C. Spitzer
Affiliation:
Department of Psychiatry and Psychotherapy, Regensburg University, Regensburg, Germany
B. Skoeries
Affiliation:
Department of Psychiatry and Psychotherapy, Regensburg University, Regensburg, Germany
T. Steinert
Affiliation:
Department of Psychiatry I, Ulm University, Ravensburg, Germany
J. Bergk
Affiliation:
Department of Psychiatry I, Ulm University, Ravensburg, Germany
J. Grempler
Affiliation:
Department of Psychiatry I, Ulm University, Ravensburg, Germany
P. Schneider
Affiliation:
Department of Psychiatry II, Ulm University, Günzburg, Germany
R. Muche
Affiliation:
Department of Biometry and Medical Documentation, Ulm University, Ulm, Germany
T. Becker
Affiliation:
Department of Psychiatry II, Ulm University, Günzburg, Germany

Abstract

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Background

Attempts to reduce high utilisation of psychiatric inpatient care by targeting the critical time of hospital discharge have been rare. In Germany, until now no such intervention has been implemented, let alone subjected to a clinical trial.

Method

“Effectiveness and Cost-Effectiveness of Needs-Oriented Discharge Planning and Monitoring for High Utilisers of Psychiatric Services” (NODPAM) is a multicentre RCT conducted in five psychiatric hospitals in Germany (Günzburg, Düsseldorf, Regensburg, Greifswald, and Ravensburg). Subjects asked to provide informed consent to participate have to be of adult age with a primary diagnosis of schizophrenia or affective disorder, and a defined high utilisation of psychiatric care during two years prior to the current admission. Subjects are asked to provide detailed outcome data at four measurement points during a period of 18 months. Recruitment (which started in April 06) is still ongoing. Thus, baseline data of about 350 participants will be presented.

Results

Recruitment has been quite successful and the study has been generally well accepted by participating patients and their clinicians in in- and outpatient treatment settings. Subjects showed substantial initial impairment on outcome measures (e.g. needs, psychopathology, quality of life, and level of functioning) and high utilisation of mental health care. Further results on conduct and feasibility of the trial will be presented.

Conclusions

The first phase of this mulicentre trial was promising. The potential of this study to strengthen the integration of mental health care provision in Germany will be discussed.

Type
S15. Symposium: Transition from Psychiatric in Patient to Community Care: A European Perspective (Organised By The AEP Section On Epidemiology And Social Psychiatry)
Copyright
Copyright © European Psychiatric Association 2007
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