Effectiveness of a Low-Intensity Home-Based Aftercare for Patients with Severe Mental Disorders: A 12-month Randomized Controlled Study

Sharifi, Vandad; Tehrani‐Doost, Mehdi; Yunesian, Masud; Amini, Homayoun; Mohammadi, Mohammad-Reza; Roudsari, Mohsen Jalali

doi:10.1007/s10597-012-9516-z

Cited by 35 publications

(59 citation statements)

References 18 publications

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“…However, more GP treatment time was found to increase the risk for rehospitalisation in one study [52], while just being registered with a primary care unit did not make a significant difference in another [33]. In a randomized controlled study, Sharifi et al found that when a GP and a social worker made home visits once during the month after discharge from the hospital wherein they provided education and treatment (home aftercare), it led to a reduction in rehospitalisation rate [53]. Similar results were obtained when the home visits were conducted by psychiatric nurses only [54, 55].…”

Section: Resultsmentioning

confidence: 99%

Overview of post-discharge predictors for psychiatric re-hospitalisations: a systematic review of the literature

et al. 2017

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Background: High levels of hospital readmission (rehospitalisation rates) is widely used as indicator of a poor quality of care. This is sometimes also referred to as recidivism or heavy utilization. Previous studies have examined a number of factors likely to influence readmission, although a systematic review of research on post-discharge factors and readmissions has not been conducted so far. The main objective of this review was to identify frequently reported post-discharge factors and their effects on readmission rates. Methods: Studies on the association between post-discharge variables and readmission after an index discharge with a main psychiatric diagnosis were searched in the bibliographic databases Ovid Medline, PsycINFO, ProQuest Health Management, OpenGrey and Google Scholar. Relevant articles published between January 1990 and June 2014 were included. A systematic approach was used to extract and organize in categories the information about post-discharge factors associated with readmission rates.

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Section: Resultsmentioning

confidence: 99%

Overview of post-discharge predictors for psychiatric re-hospitalisations: a systematic review of the literature

et al. 2017

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“…); Their findings on clinical efficacy showed a similar reduction in re‐hospitalisation, psychotic and depressive symptoms as well as an increase in clinical global impression (Sharifi et al . ).…”

Section: Discussionmentioning

confidence: 97%

Cost-effectiveness of aftercare services for people with severe mental disorders: an analysis parallel to a randomised controlled clinical trial in Iran

Moradi‐Lakeh

Yaghoubi

Hajebi

et al. 2017

Health Soc Care Community

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Aftercare services are not part of the usual care for people with severe mental disorders in Iran. This study was performed to assess the cost-effectiveness of aftercare services, including telephone follow-up or home visit, in addition to caregivers' education and training of social skills, for all subjects during the 20 months after hospital discharge. An economic evaluation was performed along with a registered randomised controlled trial (IRCT201009052557N2) on two groups of 60 persons recruited between 2010 and 2012. Intervention's effectiveness was measured by psychopathology and quality of life indicators. Cost-effectiveness and cost-utility were analysed from the societal and Ministry of Health (MoH) perspectives. All indicators of psychopathology, quality of life and satisfaction with services in the intervention group were significantly different from the control group. Mean intervention costs was US$674 (95% confidence interval [CI]: 572-776) per subject in the intervention group. Average total direct costs were US$1445 (95% CI: 1086-1804) and US$1640 (95% CI: 1087-2093) per subject in the intervention and control groups respectively. From the societal perspective, intervention had more effects with lower costs. The ratios for incremental cost-effectiveness was US$8399.1 (95% CI: 8178.2-8620.0) per quality-adjusted life year (QALY) gained from the MoH perspective for 20 months of follow-up. This study showed that aftercare services can create opportunities to use hospital beds more efficiently for unmet needs of people with psychiatric disorders. Indirect and intangible costs were not considered in this study, if taken into account, they are likely to further increase the efficiency of intervention.

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“…The development of AFTH could facilitate alignment with those international recommendations through two main mechanisms. First, previous international research has shown the benefit of AFTH, in particular in terms of increased quality of life, clinical outcomes, adherence to treatment, accessibility and continuity of care [27,28,29,30,31,32,33]. This suggests that AFTH have the potential to decrease patients’ severity of illness through increased quality of care.…”

Section: Introductionmentioning

confidence: 99%

The Development of Psychiatric Services Providing an Alternative to Full-Time Hospitalization Is Associated with Shorter Length of Stay in French Public Psychiatry

Gandré

Gervaix

Thillard

et al. 2017

IJERPH

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International recommendations for mental health care have advocated for a reduction in the length of stay (LOS) in full-time hospitalization and the development of alternatives to full-time hospitalizations (AFTH) could facilitate alignment with those recommendations. Our objective was therefore to assess whether the development of AFTH in French psychiatric sectors was associated with a reduction in the LOS in full-time hospitalization. Using data from the French national discharge database of psychiatric care, we computed the LOS of patients admitted for full-time hospitalization. The level of development of AFTH was estimated by the share of human resources allocated to those alternatives in the hospital enrolling the staff of each sector. Multi-level modelling was carried out to adjust the analysis on other factors potentially associated with the LOS (patients’, psychiatric sectors’ and environmental characteristics). We observed considerable variations in the LOS between sectors. Although the majority of these variations resulted from patients’ characteristics, a significant negative association was found between the LOS and the development of AFTH, after adjusting for other factors. Our results provide first evidence of the impact of the development of AFTH on mental health care and will provide a lever for policy makers to further develop these alternatives.

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Effectiveness of a Low-Intensity Home-Based Aftercare for Patients with Severe Mental Disorders: A 12-month Randomized Controlled Study

Cited by 35 publications

References 18 publications

Overview of post-discharge predictors for psychiatric re-hospitalisations: a systematic review of the literature

Overview of post-discharge predictors for psychiatric re-hospitalisations: a systematic review of the literature

Cost-effectiveness of aftercare services for people with severe mental disorders: an analysis parallel to a randomised controlled clinical trial in Iran

The Development of Psychiatric Services Providing an Alternative to Full-Time Hospitalization Is Associated with Shorter Length of Stay in French Public Psychiatry

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