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首页> 外文期刊>The British journal of psychiatry : >Home treatment for acute mental healthcare: randomised controlled trial
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Home treatment for acute mental healthcare: randomised controlled trial

机译：急性精神保健的家庭治疗：随机对照试验

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Background Home treatment has been proposed as an alternative to acute in-patient care for mentally ill patients. However, there is only moderate evidence in support of home treatment. Aims To test whether and to what degree home treatment services would enable a reduction (substitution) of hospital use. Method A total of 707 consecutively admitted adult patients with a broad spectrum of mental disorders (ICD-10: F2-F6, F8-F9, Z) experiencing crises that necessitated immediate admission to hospital, were randomly allocated to either a service model including a home treatment alternative to hospital care (experimental group) or a conventional service model that lacked a home treatment alternative to in-patient care (control group) (trial registration at ClinicalTrials.gov: NCT02322437). Results The mean number of hospital days per patient within 24 months after the index crisis necessitating hospital admission (primary outcome) was reduced by 30.4 (mean 41.3 v. 59.3, P<0.001) when a home treatment team was available (intention-to-treat analysis). Regarding secondary outcomes, average overall treatment duration (hospital days + home treatment days) per patient (mean 50.4 v. 59.3, P = 0.969) and mean number of hospital admissions per patient (mean 1.86 v. 1.93, P = 0.885) did not differ statistically significantly between the experimental and control groups within 24 months after the index crisis. There were no significant between-group differences regarding clinical and social outcomes (Health of the Nation Outcome Scales: mean 9.9 v. 9.7, P = 0.652) or patient satisfaction with care (Perception of Care questionnaire: mean 0.78 v. 0.80, P = 0.242). Conclusions Home treatment services can reduce hospital use among severely ill patients in acute crises and seem to result in comparable clinical/social outcomes and patient satisfaction as standard in-patient care.
机译：背景 家庭治疗已被提议作为精神病患者急性住院护理的替代方案。然而，只有中等证据支持家庭治疗。目的 测试家庭治疗服务是否以及在多大程度上能够减少（替代）医院的使用。方法 将707例连续入院的患有广泛精神障碍（ICD-10：F2-F6、F8-F9、Z）的成年患者随机分配到包括住院治疗替代家庭治疗的服务模式（实验组）或缺乏住院治疗替代家庭治疗的传统服务模式（对照组）（试验注册 ClinicalTrials.gov： NCT02322437）。结果 当有家庭治疗团队可用时，需要住院的指数危机后 24 个月内每位患者的平均住院天数（主要结局）减少了 30.4%（平均值 41.3 v. 59.3，P<0.001）（意向性治疗分析）。关于次要结局，在指数危机后 24 个月内，实验组和对照组的平均总治疗持续时间（住院天数 + 家庭治疗天数）（平均 50.4 v. 59.3，P = 0.969）和每位患者的平均住院次数（平均 1.86 v. 1.93，P = 0.885）在指标危机后 24 个月内在实验组和对照组之间没有统计学显着差异。在临床和社会结局（国家健康结局量表：平均 9.9 v. 9.7，P = 0.652）或患者对护理的满意度（护理感知问卷：平均 0.78 v. 0.80，P = 0.242）方面，组间差异无统计学意义。结论 家庭治疗服务可以减少急性危象重症患者的住院使用，并且似乎与标准住院治疗具有相当的临床/社会结局和患者满意度。

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