[An observational study of 'assertive outreach' with remission as outcome measure]

(Een observationele trial naar 'assertive outreach' met remissie als uitkomstmaat1.)

Full Abstract

BACKGROUND:
Systems of intensive care such as the Function Assertive Community Treatment (Function-act) are advocated because they are reported to have achieved very promising results. However, comparative studies aimed at measuring the efficacy of such systems are mainly of short duration and the outcome measure is nearly always the amount of care provided.

AIM:
To investigate, via an observational study, changes that occurred in the number of patients going into remission and in the amount of care provided before and after the introduction of f-act.

METHOD:
f-act was introduced in Maastricht and the surrounding area (population 220,000) at the beginning of 2002. Cumulative routine measurements of the effect of care in the region had been performed since 1998. These measurements were used to compare the proportion of patients in remission in two non-overlapping patients cohorts, each covering a 4-year period, namely 1998-2001 and 2002-2005. results The proportion of patients who made the transition to remission increased from 19% in the period before the introduction of f-act to 31% in the period after its introduction (or = 2.21; 95% ci:
1.03-4.78), but after controlling for confounders the difference was no longer statistically significant.

CONCLUSION:
In routine clinical practice f-act can reduce the intensity of psychopathological symptoms, possibly because the care provided under f-act is less fragmented. However, more research is needed before the claimed beneficial effects of f-act can be proved conclusively.

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Author information

Author/s: Bak, M (M); Drukker, M (M); de Bie, A (A); A Campo, J (J); Poddighe, G (G); van Os, J (J); Delespaul, Ph (P);

Affiliation: Capaciteitsgroep psychiatrie en neuropsychologie, Universiteit Maastricht, Postbus 616, 6200 MD Maastricht. m.bak@sp.unimaas.nl

Journal and publication information

Publication Type: English Abstract; Journal Article

Journal: Tijdschrift voor psychiatrie (Tijdschr Psychiatr), published in Netherlands. (Language: dut)

Reference: 2008-; vol 50 (issue 5) : pp 253-62

Dates: Created 2008/05/12; Completed 2008/07/22;

PMID: 18470840, status: MEDLINE (last retrieval date: 11/6/2008)

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MeSH headings (categories)

This article was linked to the MESH Headings shown below.

Adult
Aged
Assertiveness
Catchment Area (Health)
Community Mental Health Services - methods; standards
Female
Humans
Male

Mental Disorders - therapy
Middle Aged
Netherlands
Outcome and Process Assessment (Health Care)
Quality of Health Care
Quality of Life
Remission Induction
Treatment Outcome

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