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Four-year outcome in non-compliant schizophrenia patients treated with or without home-based ambulatory outpatient care

Published online by Cambridge University Press:  16 April 2020

O. Kampman ,
A. Illi ,
P. Poutanen  and
E. Leinonen
O. Kampman*
Affiliation:
University of Tampere, Medical School, 33014, Finland Tampere Community Mental Health Care, Finland
A. Illi
Affiliation:
Department of Psychiatry, Tampere University Hospital, Finland
P. Poutanen
Affiliation:
Department of Psychiatry, Tampere University Hospital, Finland
E. Leinonen
Affiliation:
University of Tampere, Medical School, 33014, Finland Department of Psychiatry, Tampere University Hospital, Finland
*
*E-mail address: [email protected]
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Abstract

Non-compliance in neuroleptic maintenance treatment is a major concern in schizophrenia. Home-based outpatient care has been shown both to improve medication compliance and reduce relapse frequency. We analysed the need for hospitalisation, levels of functioning and mortality rate during the de-institutionalisation process in 41 schizophrenia patients with repeated hospitalisations and prolonged history of non-compliance. Eighteen of the patients received ambulatory outpatient care (AOC) after discharge. This treatment procedure focuses on enduring neuroleptic maintenance treatment. One of the hospital nurses takes care of home visits every 2–4 weeks. In the 4-year follow-up, half of the patients in the AOC group did not need hospitalisation at all and the number of days of hospitalisation in the whole group diminished by almost four-fifths compared with the previous 4 years. In the non-AOC group, there was a more limited decrease in the number of days of hospitalisation during the corresponding follow-up period. The mortality rates showed a slight tendency towards a better outcome in the AOC group. There was no change in the levels of functioning in the AOC group. This treatment can be carried out with limited resources. It clearly reduces the need for hospitalisation in a subgroup of schizophrenia patients having problems with compliance and recurrent relapse. The effectiveness of AOC on the mortality rates of schizophrenia patients needs further examination.

Keywords

SchizophreniaComplianceRelapseAmbulatory careMortality
Type
Original article
Information
European Psychiatry , Volume 18 , Issue 1 , February 2003 , pp. 1 - 5
Copyright
Copyright © Éditions scientifiques et médicales Elsevier SAS 2002

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