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.

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.

Capsular closure versus unrepaired interportal capsulotomy after hip arthroscopy in patients with femoroacetabular impingement, results of a patient-blinded randomised controlled trial

2021 ◽  
pp. 112070002110057
Author(s):  
Niels H Bech ◽  
Inger N Sierevelt ◽  
Sheryl de Waard ◽  
Boudijn S H Joling ◽  
Gino M M J Kerkhoffs ◽  
...  
Keyword(s):  
Randomised Controlled Trial ◽  
Femoroacetabular Impingement ◽  
Hip Arthroscopy ◽  
Controlled Trial ◽  
Poor Quality ◽  
Control Group ◽  
Treatment Groups ◽  
Significant Difference ◽  
Randomised Controlled

Background: Hip capsular management after hip arthroscopy remains a topic of debate. Most available current literature is of poor quality and are retrospective or cohort studies. As of today, no clear consensus exists on capsular management after hip arthroscopy. Purpose: To evaluate the effect of routine capsular closure versus unrepaired capsulotomy after interportal capsulotomy measured with NRS pain and the Copenhagen Hip and Groin Outcome Score (HAGOS). Materials and methods: All eligible patients with femoroacetabular impingement who opt for hip arthroscopy ( n = 116) were randomly assigned to one of both treatment groups and were operated by a single surgeon. Postoperative pain was measured with the NRS score weekly the first 12 weeks after surgery. The HAGOS questionnaire was measured at 12 and 52 weeks postoperatively. Results: Baseline characteristics and operation details were comparable between treatment groups. Regarding the NRS pain no significant difference was found between groups at any point the first 12 weeks after surgery ( p = 0.67). Both groups significantly improved after surgery ( p < 0.001). After 3 months follow-up there were no differences between groups for the HAGOS questionnaire except for the domain sport ( p = 0.02) in favour of the control group. After 12 months follow-up there were no differences between both treatment groups on all HAGOS domains ( p  > 0.05). Conclusions: The results of this randomised controlled trial show highest possible evidence that there is no reason for routinely capsular closure after interportal capsulotomy at the end of hip arthroscopy. Trial Registration: This trial was registered at the CCMO Dutch Trial Register: NL55669.048.15.

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 Cost-effectiveness of intensive v. standard case management for severe psychotic illness

2000 ◽  
Vol 176 (6) ◽  
pp. 537-543 ◽  
Author(s):  
◽  
Sarah Byford ◽  
Matthew Fiander ◽  
David J. Torgerson ◽  
Julie A. Barber ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Case Management ◽  
Hospital Admissions ◽  
Intensive Case Management ◽  
Standard Case ◽  
Severely Mentally Ill ◽  
Significant Difference ◽  
African Caribbean ◽  
Standard Case Management ◽  
The Cost

BackgroundIntensive case management is commonly advocated for the care of the severely mentally ill, but evidence of its cost-effectiveness is lacking.AimsTo investigate the cost-effectiveness of intensive compared with standard case management for patients with severe psychosis.Method708 patients with psychosis and a history of repeated hospital admissions were randomly allocated to standard (case-loads 30–35) or intensive (case-loads 10–15) case management. Clinical and resource use data were assessed over two years.ResultsNo statistically significant difference was found between intensive and standard case management in the total two-year costs of care per patient (means £24 550 and £22 700, respectively, difference £1850, 95% Cl – £1600 to £5300). There was no evidence of differential effects in African–Caribbean patients or in the most disabled. Psychiatric in-patient hospital stay accounted for 47% of the total costs, but neither such hospitalisation nor other clinical outcomes differed between the randomised groups.ConclusionReduced case-loads have no clear beneficial effect on costs, clinical outcome or cost-effectiveness. The policy of advocating intensive case management for patients with severe psychosis is not supported by these results.

scholarly journals Coordinated care versus standard care in hospital admissions of people with chronic illness: a randomised controlled trial

2015 ◽  
Vol 203 (1) ◽  
pp. 33-38 ◽  
Author(s):  
Natalie A Plant ◽  
Patrick J Kelly ◽  
Stephen R Leeder ◽  
Mario D'Souza ◽  
Kylie‐Ann Mallitt ◽  
...  
Keyword(s):  
Chronic Illness ◽  
Randomised Controlled Trial ◽  
Standard Care ◽  
Hospital Admissions ◽  
Controlled Trial ◽  
Coordinated Care ◽  
Randomised Controlled

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.

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.

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