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NCT Number: NCT02322437

Home Treatment for Acute Psychiatric Care

This study aims to evaluate whether psychiatric home treatment is an effective and efficient alternative to acute inpatient care in mental hospitals. A one-year prevalence cohort of psychiatric patients in need of hospitalization are randomly assigned to either treatment at inpatient wards (treatment as usual) or a new care model with the additional option of treating patients at their homes by mobile care teams. The primary focus is on checking whether optional home treatment leads to a reduction of inpatient days during a two-year follow-up period. In addition, the two service models will be compared regarding treatment cost and outcomes as well as satisfaction of patients and their relatives with psychiatric care.

Furthermore, a sub-cohort of randomly chosen patients from the prevalence-cohort will be examined by a highly trained clinical assessor to test and verify the diagnoses and the clinical ratings made by the staff members of the mental hospital under routine everyday conditions.

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Key information

Conditions

Mental Disorders

Age range

18 year–64 year

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

Primary location

Psychiatric Services Aargau AG

Brugg, Canton of Aargau, 5201, Switzerland

About this study

This study aims to evaluate whether psychiatric home treatment is an effective and efficient alternative to acute inpatient care in mental hospitals. A one-year prevalence cohort of psychiatric patients in need of hospitalization are randomly assigned to either treatment at inpatient wards (treatment as usual) or a new care model with the additional option of treating patients at their homes by mobile care teams. The primary focus is on checking whether optional home treatment for crisis intervention leads to a reduction of inpatient days during a two-year follow-up period. In addition, the two service models will be compared regarding treatment cost and outcomes as well as satisfaction of patients and their relatives with psychiatric care.

Furthermore, a sub-cohort of randomly chosen patients from the prevalence-cohort will be examined by a highly trained clinical assessor to test and verify the diagnoses (SCID-I and SCID-II) and the clinical ratings (HoNOS) made by the staff members of the mental hospital under routine everyday conditions.

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • Need for acute psychiatric inpatient care
  • Residence in the canton of Aargau
  • Living within 30 minutes (by car) from the headquarters of the home treatment team
  • Health insurance with tarifsuisse

Exclusion criteria

  • Insufficient proficiency in German
  • Main diagnosis F0 or F1 (ICD-10)
  • Patients of the forencic departement
  • Patients of the child and adolescent department

Treatment and study plan

Home treatment

Other

Patients are treated at home whenever possible and appropriate

Treatment as Usual

Other

Patients are treated at a mental hospital

Primary outcomes

  1. Number of inpatient days

    Time frame: 2 years follow-up

Secondary outcomes

  1. Total days in treatment (inpatient + home treatment)

    Time frame: 2 years follow-up

  2. Direct treatment costs

    Time frame: 2 years follow-up

  3. Health of the Nation Outcome Scales (HoNOS)

    Time frame: Intake and discharge from treatment episode (expected average of 4 weeks)

    Participants will be followed for the duration of hospital stay, an expected average of 4 weeks.

  4. Brief Symptom Checklist (BSCL)

    Time frame: Intake and discharge from treatment episode (expected average of 4 weeks)

    Participants will be followed for the duration of hospital stay, an expected average of 4 weeks.

  5. Perceptions of Care-18

    Time frame: Discharge from treatment episode (expected average of 4 weeks)

    Participants will be assessed at discharge from hospital, after an expected average of 4 weeks.

  6. Satisfaction of patients' relatives

    Time frame: Discharge from treatment episode (expected average of 4 weeks)

    Relatives' satisfaction will be assessed with an adapted version of the Perceptions of Care-18 questionnaire at discharge of the patients from hospital, after an expected average of 4 weeks. The proportion of satisfied relatives will be reported for both study arms.

  7. Number of rehospitalizations per patient

    Time frame: 2 years follow-up

  8. Number of patients with adverse events

    Time frame: 2 years follow-up

    E.g. suicide or attempted suicide.

Sponsors and collaborators

Lead sponsor

Psychiatric Services Aargau AG

Other

Collaborators

  • Hugo & Elsa Isler Foundation

Registry information

Official study title

Home Treatment for Acute Psychiatric Care in the Canton of Aargau (Switzerland): A Randomized Controlled Trial

Important dates

Study start
2015
Primary completion
2018
Study completion
2018
First posted
Dec 23, 2014
Registry last updated
Jun 6, 2018

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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