scholarly journals Intellectual functioning and outcome of patients with severe psychotic illness randomised to intensive case management

2001 ◽  
Vol 178 (2) ◽  
pp. 166-171 ◽  
Author(s):  
A. Hassiotis ◽  
O. C. Ukoumunne ◽  
S. Byford ◽  
P. Tyrer ◽  
K. Harvey ◽  
...  
Keyword(s):  
Case Management ◽  
Cognitive Deficits ◽  
Hospital Admissions ◽  
Controlled Trial ◽  
Cost Effective ◽  
Intensive Case Management ◽  
Psychotic Illness ◽  
Costs Of Care ◽  
Randomised Controlled ◽  
Borderline Iq

BackgroundLittle research has been carried out on the benefits of intensive case management (ICM) for people with borderline IQ and severe mental illness.AimsTo compare outcome and costs of care of patients with severe psychotic illness with borderline IQ to patients of normal IQ and to assess whether ICM is more beneficial for the former than for the latter.MethodThe study utilises data from the UK700 multi-centre randomised controlled trial of case management. The main outcome measure was the number of days spent in hospital for psychiatric reasons. Secondary outcomes were costs of care and clinical outcome.ResultsICM was significantly more beneficial for borderline-IQ patients than those of normal IQ in terms of reductions in days spent in hospital, hospital admissions, total costs and needs and increased satisfaction.ConclusionsICM appears to be a cost-effective strategy for a subgroup of patients with severe psychosis with cognitive deficits.

scholarly journals Suicidal behaviour in psychosis: Prevalence and predictors from a randomised controlled trial of case management

2001 ◽  
Vol 178 (3) ◽  
pp. 255-260 ◽  
Author(s):  
Elizabeth Walsh ◽  
Kate Harvey ◽  
Ian White ◽  
Anna Higgitt ◽  
Janelle Fraser ◽  
...  
Keyword(s):  
Case Management ◽  
Suicidal Behaviour ◽  
Standard Care ◽  
Hospital Admissions ◽  
Controlled Trial ◽  
Intensive Case Management ◽  
Treatment Groups ◽  
Significant Difference ◽  
Randomised Controlled ◽  
Chronic Psychosis

BackgroundIt is unclear whether intensive case management influences the prevalence of suicidal behaviour in patients with psychosis.AimsTo compare the effect of intensive case management and standard care on prevalence of suicidal behaviour in patients with chronic psychosis.MethodPatients with established psychosis (n=708) were randomised either to intensive case management or to standard care. The prevalence of suicidal behaviour was estimated at 2-year follow-up and compared between treatment groups. Suicide attempters and non-attempters were compared on multiple socio-demographic and clinical variables to identify predictors of suicidal behaviour.ResultsThere was no significant difference in prevalence of suicidal behaviour between treatment groups. Recent attempts at suicide and multiple recent hospital admissions best predicted future attempts.ConclusionsIntensive case management does not appear to influence the prevalence of suicidal behaviour in chronic psychosis. Predictors identified in this study confirm some previous findings.

Personality abnormality in severe mental illness and its influence on outcome of intensive and standard case management: a randomised controlled trial

2000 ◽  
Vol 15 (S1) ◽  
pp. 7-10 ◽  
Author(s):  
P. Tyrer ◽  
C. Manley ◽  
E. Van Horn ◽  
D. Leddy ◽  
O.C. Ukoumunne
Keyword(s):  
Personality Disorder ◽  
Case Management ◽  
Primary Outcome ◽  
Controlled Trial ◽  
Intensive Case Management ◽  
Psychotic Illness ◽  
Standard Case ◽  
Weak Evidence ◽  
Randomised Controlled ◽  
Standard Case Management

SummaryOne hundred fifty-five (77%) of 201 participants recruited in a trial of intensive vs standard case management of patients with recurrent psychotic illness had their personality status measured before treatment and were followed up for two years. The primary outcome was the total number of days spent in psychiatric hospitalisation in the two years following randomisation. Thirty-three (21%) of the patients had a personality disorder and their duration of hospital stay (105 days) was greater than in those without personality disorder (56 days). There was weak evidence that intensive case management more effective in reducing the duration of care in those with personality disorder than in those without personality disorder.

Comparison of intensive and standard case management for patients with psychosis

1999 ◽  
Vol 174 (1) ◽  
pp. 74-78 ◽  
Author(s):  
Francis Creed ◽  
Tom Burns ◽  
Tom Butler ◽  
Sarah Byford ◽  
Robin Murray ◽  
...  
Keyword(s):  
Case Management ◽  
Controlled Trial ◽  
Outcome Data ◽  
Cost Of Care ◽  
Intensive Case Management ◽  
Standard Case ◽  
Case Load ◽  
African Caribbean ◽  
Randomised Controlled ◽  
Standard Case Management

BackgroundCase management, particularly in intensive form, has been widely introduced for the treatment of severe mental illness. However, the optimal intensity of case management has not been determined.AimsWe aimed to assess whether intensive case management (small case load) reduces hospitalisation and costs compared with standard case management.MethodDevelopment and rationale of a large randomised controlled trial comparing intensive case management (case load per worker? 15 patients) with standard case management (case load 30–35 patients)ResultsTwo-year outcome data will be obtained on patients representative of the seriously mentally ill in inner-city mental health services.ConclusionsThe study planned with 700 patients should be sufficient to detect small differences in the readmission of patients to hospital (10%), the number of days spent in hospital over a two-year period (10 days) and the average weekly cost of care per patient. The sample is large enough to compare the cost-effectiveness of intensive and standard case management in mild and severe disability and in people of African–Caribbean origin and White Caucasians.

scholarly journals Reducing utilisation of hospital services by case management: a randomised controlled trial

2004 ◽  
Vol 28 (1) ◽  
pp. 79 ◽  
Author(s):  
Antony C T Leung ◽  
Daniel C N Yau ◽  
Chi-pun Liu ◽  
Chak-sum Yeoh ◽  
Tak-yi Chui ◽  
...  
Keyword(s):  
Randomised Controlled Trial ◽  
Elderly Patients ◽  
Case Management ◽  
Hospital Admissions ◽  
Controlled Trial ◽  
Intervention Group ◽  
Control Group ◽  
Hospital Services ◽  
Post Intervention ◽  
Randomised Controlled

A 12-month randomised controlled trial was conducted in Hong Kong to evaluate the effectiveness of case management provided to a group of home-dwelling, frail elderly patients (control group: n = 47; intervention group: n = 45) in terms of utilisation of hospital services by these patients. Significant reductions (significance at P<0.05) in mean total number of hospital bed-days (P<0.001), mean total episodes of hospital admissions (P<0.001), and mean total number of attendances at the outpatient department (P< 0.05) were observed when the baseline and post-intervention differences between the intervention and control groups were compared. The study demonstrated that utilisation of hospital services could be significantly reduced when a group of elderly patients and their caregivers received timely interventions and appropriate services through case management services.

scholarly journals Emergency Medicine Palliative Care Access (EMPallA): protocol for a multicentre randomised controlled trial comparing the effectiveness of specialty outpatient versus nurse-led telephonic palliative care of older adults with advanced illness

BMJ Open ◽  
2019 ◽  
Vol 9 (1) ◽  
pp. e025692 ◽  
Author(s):  
Corita R Grudzen ◽  
Deborah J Shim ◽  
Abigail M Schmucker ◽  
Jeanne Cho ◽  
Keith S Goldfeld
Keyword(s):  
Quality Of Life ◽  
Older Adults ◽  
Palliative Care ◽  
Randomised Controlled Trial ◽  
Case Management ◽  
Controlled Trial ◽  
Chronic Obstructive ◽  
Randomised Controlled ◽  
End Stage

IntroductionEmergency department (ED)-initiated palliative care has been shown to improve patient-centred outcomes in older adults with serious, life-limiting illnesses. However, the optimal modality for providing such interventions is unknown. This study aims to compare nurse-led telephonic case management to specialty outpatient palliative care for older adults with serious, life-limiting illness on: (1) quality of life in patients; (2) healthcare utilisation; (3) loneliness and symptom burden and (4) caregiver strain, caregiver quality of life and bereavement.Methods and analysisThis is a protocol for a pragmatic, multicentre, parallel, two-arm randomised controlled trial in ED patients comparing two established models of palliative care: nurse-led telephonic case management and specialty, outpatient palliative care. We will enrol 1350 patients aged 50+ years and 675 of their caregivers across nine EDs. Eligible patients: (1) have advanced cancer (metastatic solid tumour) or end-stage organ failure (New York Heart Association class III or IV heart failure, end-stage renal disease with glomerular filtration rate <15 mL/min/m2, or global initiative for chronic obstructive lung disease stage III, IV or oxygen-dependent chronic obstructive pulmonary disease); (2) speak English; (3) are scheduled for ED discharge or observation status; (4) reside locally; (5) have a working telephone and (6) are insured. Patients will be excluded if they: (1) have dementia; (2) have received hospice care or two or more palliative care visits in the last 6 months or (3) reside in a long-term care facility. We will use patient-level block randomisation, stratified by ED site and disease. Effectiveness will be compared by measuring the impact of each intervention on the specified outcomes. The primary outcome will measure change in patient quality of life.Ethics and disseminationInstitutional Review Board approval was obtained at all study sites. Trial results will be submitted for publication in a peer-reviewed journal.Trial registration numberNCT03325985; Pre-results.

scholarly journals The improvement of cognitive deficits after whole-body cryotherapy – A randomised controlled trial

2021 ◽  
Vol 146 ◽  
pp. 111237
Author(s):  
Joanna Rymaszewska ◽  
Katarzyna M. Lion ◽  
Bartłomiej Stańczykiewicz ◽  
Julia E. Rymaszewska ◽  
Elżbieta Trypka ◽  
...  
Keyword(s):  
Randomised Controlled Trial ◽  
Cognitive Deficits ◽  
Controlled Trial ◽  
Whole Body ◽  
Randomised Controlled ◽  
Whole Body Cryotherapy
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