Article

Treatment Outcome in Patients Receiving Assertive Community Treatment

Parnassia Bavo Group, BavoEuropoort, Westersingel 94, 3015 LC, Rotterdam, The Netherlands.
Community Mental Health Journal (Impact Factor: 1.03). 10/2009; 46(4):330-6. DOI: 10.1007/s10597-009-9257-9
Source: PubMed

ABSTRACT

In an observational study of severely mentally ill patients treated in assertive community treatment (ACT) teams, we investigated how treatment outcome was associated with demographic factors, clinical factors, and motivation for treatment. To determine psychosocial outcome, patients were routinely assessed using the Health of the Nation Outcome Scales (HoNOS). Trends over time were analyzed using a mixed model with repeated measures. The HoNOS total score was modeled as a function of treatment duration and patient-dependent covariates. Data comprised 637 assessments of 139 patients; mean duration of follow-up was 27.4 months (SD = 5.4). Substance abuse, higher age, problems with motivation, and lower educational level were associated with higher HoNOS total scores (i.e., worse outcome). To improve treatment outcome, we recommend better implementation of ACT, and also the implementation of additional programs targeting subgroups which seem to benefit less from ACT.

Download full-text

Full-text

Available from: Durk Wiersma
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Routine outcome monitoring (ROM) means the assessment of the patient's condition on a routine basis using instruments. So far there is no consensus about which instruments should be used for ROM with severely mentally ill patients (ROM-SMI). To reach a consensus about instruments for ROM-SMI in the Netherlands and Belgium and to create possibilities for comparison of ROM data. This article discusses the consensus document of the National Remission Working Group for ROM in patients with smi and covers the following topics: reasons for ROM-SMI, domains for ROM-SMI and appropriate instruments, logistics and analyses of the data. Patients with SMI have problems in several domains. These can be assessed by collecting information about psychiatric symptoms, addiction, somatic problems, general functioning, needs, quality of life and care satisfaction. Potential instruments for ROM-SMI are short, valid, reliable and assess several domains, taking the patient's perspective into account, and have been used in national and international research. The working group advises institutions to choose from a limited set of instruments. After the scores have been aggregated and standardised, comparisons can be drawn. ROM-SMI data can be interpreted more meaningfully, if outcome data are supplemented with data regarding patient characteristics and the treatment interventions already applied. It should be possible to reach a consensus about instruments for ROM-SMI and the way in which they should be used. The use of identical instruments will lead to improvements in mental health care and create possibilities for comparison (benchmarking) and research.
    Full-text · Article · Jan 2010 · Tijdschrift voor psychiatrie
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: BACKGROUND: Routine outcome monitoring (rom) means the assessment of the patient's condition on a routine basis using instruments. So far there is no consensus about which instruments should be used for rom with severely mentally ill patients (rom-smi). AIM: To reach a consensus about instruments for rom-smi in the Netherlands and Belgium and to create possibilities for comparison of rom data. METHOD: This article discusses the consensus document of the National Remission Working Group for rom in patients with smi and covers the following topics: reasons for rom-smi, domains for rom-smi and appropriate instruments, logistics and analyses of the data. results Patients with smi have problems in several domains. These can be assessed by collecting information about psychiatric symptoms, addiction, somatic problems, general functioning, needs, quality of life and care satisfaction. Potential instruments for rom-smi are short, valid, reliable and assess several domains, taking the patient's perspective into account, and have been used in national and international research. The working group advises institutions to choose from a limited set of instruments. After the scores have been aggregated and standardised, comparisons can be drawn. rom-smi data can be interpreted more meaningfully, if outcome data are supplemented with data regarding patient characteristics and the treatment interventions already applied. CONCLUSION: It should be possible to reach a consensus about instruments for romsmi and the way in which they should be used. The use of identical instruments will lead to improvements in mental health care and create possibilities for comparison (benchmarking) and research
    Full-text · Article · Jan 2010
  • Source

    Full-text · Article · Mar 2011 · Journal of the American Psychiatric Nurses Association
Show more