The Post-Discharge Network Coordination Programme (PDNC-P): A randomised controlled trial to evaluate the efficacy of an intervention aimed at reducing rehospitalisations and improving mental health
Purpose: To evaluate the efficacy of a post-discharge intervention for psychiatric inpatients aimed at preventing hospital readmissions and at improving patients’ mental health and psychosocial functioning. Methods: RCT using parallel group block randomisation including 151 patients with ≤3 hospital...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2016-03-01
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| Series: | Frontiers in Psychiatry |
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| Online Access: | http://journal.frontiersin.org/Journal/10.3389/fpsyt.2016.00027/full |
| _version_ | 1818154993493999616 |
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| author | Michael Pascal Hengartner Silvia ePassalacqua Gisela eHeim Andreas eAndreae Wulf eRössler Wulf eRössler Agnes eVon Wyl |
| author_facet | Michael Pascal Hengartner Silvia ePassalacqua Gisela eHeim Andreas eAndreae Wulf eRössler Wulf eRössler Agnes eVon Wyl |
| author_sort | Michael Pascal Hengartner |
| collection | DOAJ |
| description | Purpose: To evaluate the efficacy of a post-discharge intervention for psychiatric inpatients aimed at preventing hospital readmissions and at improving patients’ mental health and psychosocial functioning. Methods: RCT using parallel group block randomisation including 151 patients with ≤3 hospitalisations within the last three years, a GAF score ≤60, and aged 18–64 years, assessed at two psychiatric hospitals from the canton of Zurich, Switzerland, between September 2011 and February 2014. Primary outcomes were rate and duration of rehospitalisation; secondary outcomes were mental health and functioning. Outcome measures were assessed before discharge from the index hospitalisation (t0), 3 months after discharge when the intervention terminated (t1), and 12 months after discharge (t2). Participants received either a brief case management post-discharge intervention or treatment as usual.Results: In the short-term (i.e., t0-t1) no significant effect emerged in any outcome. In the long-term (i.e., t0-t2) the two groups did not differ significantly with respect to the rate and duration of rehospitalisation. Also, the intervention did not reduce psychiatric symptoms, did not improve social support and did not improve quality of life. However, it did slightly increase assessor-rated general (d=0.30) and social functioning (d=0.42), although self-reports revealed a deteriorative effect on symptom remission (d=-0.44).Conclusions: This psychosocial post-discharge intervention showed no efficacy in the primary outcome of rehospitalisation. With respect to secondary outcomes, in the long-term it might lead to slightly increased social functioning but revealed no significant effect on psychopathology, social support and quality of life. In contrast, with respect to self-reported symptom remission, it was revealed to have a negative effect. In this high-resource catchment area with comprehensive community psychiatric and social services the intervention thus cannot be recommended for implementation in routine care. Funding: This study was supported by a private foundation.Trial registration: ISRCTN58280620 |
| first_indexed | 2024-12-11T14:35:20Z |
| format | Article |
| id | doaj.art-061556fa71064f87895c0bdaf87cc4d7 |
| institution | Directory Open Access Journal |
| issn | 1664-0640 |
| language | English |
| last_indexed | 2024-12-11T14:35:20Z |
| publishDate | 2016-03-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Psychiatry |
| spelling | doaj.art-061556fa71064f87895c0bdaf87cc4d72022-12-22T01:02:12ZengFrontiers Media S.A.Frontiers in Psychiatry1664-06402016-03-01710.3389/fpsyt.2016.00027183152The Post-Discharge Network Coordination Programme (PDNC-P): A randomised controlled trial to evaluate the efficacy of an intervention aimed at reducing rehospitalisations and improving mental healthMichael Pascal Hengartner0Silvia ePassalacqua1Gisela eHeim2Andreas eAndreae3Wulf eRössler4Wulf eRössler5Agnes eVon Wyl6Zurich University of Applied Sciences (ZHAW)Zurich University of Applied Sciences (ZHAW)Integrated Psychiatric Clinic of Winterthur and Zurich Unterland (ipw)Integrated Psychiatric Clinic of Winterthur and Zurich Unterland (ipw)University of ZurichUniversity of Sao PauloZurich University of Applied Sciences (ZHAW)Purpose: To evaluate the efficacy of a post-discharge intervention for psychiatric inpatients aimed at preventing hospital readmissions and at improving patients’ mental health and psychosocial functioning. Methods: RCT using parallel group block randomisation including 151 patients with ≤3 hospitalisations within the last three years, a GAF score ≤60, and aged 18–64 years, assessed at two psychiatric hospitals from the canton of Zurich, Switzerland, between September 2011 and February 2014. Primary outcomes were rate and duration of rehospitalisation; secondary outcomes were mental health and functioning. Outcome measures were assessed before discharge from the index hospitalisation (t0), 3 months after discharge when the intervention terminated (t1), and 12 months after discharge (t2). Participants received either a brief case management post-discharge intervention or treatment as usual.Results: In the short-term (i.e., t0-t1) no significant effect emerged in any outcome. In the long-term (i.e., t0-t2) the two groups did not differ significantly with respect to the rate and duration of rehospitalisation. Also, the intervention did not reduce psychiatric symptoms, did not improve social support and did not improve quality of life. However, it did slightly increase assessor-rated general (d=0.30) and social functioning (d=0.42), although self-reports revealed a deteriorative effect on symptom remission (d=-0.44).Conclusions: This psychosocial post-discharge intervention showed no efficacy in the primary outcome of rehospitalisation. With respect to secondary outcomes, in the long-term it might lead to slightly increased social functioning but revealed no significant effect on psychopathology, social support and quality of life. In contrast, with respect to self-reported symptom remission, it was revealed to have a negative effect. In this high-resource catchment area with comprehensive community psychiatric and social services the intervention thus cannot be recommended for implementation in routine care. Funding: This study was supported by a private foundation.Trial registration: ISRCTN58280620http://journal.frontiersin.org/Journal/10.3389/fpsyt.2016.00027/fullCase ManagementEpidemiologyPsychopathologySocial Worksocial psychiatryrandomized controlled trial |
| spellingShingle | Michael Pascal Hengartner Silvia ePassalacqua Gisela eHeim Andreas eAndreae Wulf eRössler Wulf eRössler Agnes eVon Wyl The Post-Discharge Network Coordination Programme (PDNC-P): A randomised controlled trial to evaluate the efficacy of an intervention aimed at reducing rehospitalisations and improving mental health Frontiers in Psychiatry Case Management Epidemiology Psychopathology Social Work social psychiatry randomized controlled trial |
| title | The Post-Discharge Network Coordination Programme (PDNC-P): A randomised controlled trial to evaluate the efficacy of an intervention aimed at reducing rehospitalisations and improving mental health |
| title_full | The Post-Discharge Network Coordination Programme (PDNC-P): A randomised controlled trial to evaluate the efficacy of an intervention aimed at reducing rehospitalisations and improving mental health |
| title_fullStr | The Post-Discharge Network Coordination Programme (PDNC-P): A randomised controlled trial to evaluate the efficacy of an intervention aimed at reducing rehospitalisations and improving mental health |
| title_full_unstemmed | The Post-Discharge Network Coordination Programme (PDNC-P): A randomised controlled trial to evaluate the efficacy of an intervention aimed at reducing rehospitalisations and improving mental health |
| title_short | The Post-Discharge Network Coordination Programme (PDNC-P): A randomised controlled trial to evaluate the efficacy of an intervention aimed at reducing rehospitalisations and improving mental health |
| title_sort | post discharge network coordination programme pdnc p a randomised controlled trial to evaluate the efficacy of an intervention aimed at reducing rehospitalisations and improving mental health |
| topic | Case Management Epidemiology Psychopathology Social Work social psychiatry randomized controlled trial |
| url | http://journal.frontiersin.org/Journal/10.3389/fpsyt.2016.00027/full |
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