Hostname: page-component-586b7cd67f-2plfb Total loading time: 0 Render date: 2024-11-22T07:42:39.325Z Has data issue: false hasContentIssue false
  • English
  • Français

Comparison of intensive and standard case management for patients with psychosis

Rationale of the trial

Published online by Cambridge University Press:  02 January 2018

Francis Creed ,
Tom Burns ,
Tom Butler ,
Sarah Byford ,
Robin Murray ,
Simon Thompson  and
Peter Tyrer
Francis Creed*
Affiliation:
Manchester Royal Infirmary, Manchester
Tom Burns
Affiliation:
St George's Hospital Medical School, London
Tom Butler
Affiliation:
National Primary Care Research & Development Centre, University of Manchester
Sarah Byford
Affiliation:
Health Economics Centre, University of York
Robin Murray
Affiliation:
Institute of Psychiatry, London
Simon Thompson
Affiliation:
St Charles' Hospital, London
Peter Tyrer
Affiliation:
St Charles' Hospital, London
*
Professor Francis Creed, Rawnsley Building, Manchester Royal Infirmary, Oxford Road, Manchester M13 9WL
Get access Rights & Permissions [Opens in a new window]

Abstract

Background

Case 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.

Aims

We aimed to assess whether intensive case management (small case load) reduces hospitalisation and costs compared with standard case management.

Method

Development 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)

Results

Two-year outcome data will be obtained on patients representative of the seriously mentally ill in inner-city mental health services.

Conclusions

The 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.

Type
Preliminary Reports
Information
The British Journal of Psychiatry , Volume 174 , Issue 1 , January 1999 , pp. 74 - 78
Copyright
Copyright © 1999 The Royal College of Psychiatrists 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Footnotes

Declaration of interest

Funded by the UK NHS Research and Development Programme and the Department of Health.

References

Bachrach, L. L. (1993) Continuity of care and approaches to case management for long-term mentally ill patients. Hospital and Community Psychiatry, 44, 465–468.Google Scholar
Baker, F. & Intagliata, J. (1992) Case management. In Handbook of Psychiatric Rehabilitation (ed. Liberman, R. P.). London: Macmillan.Google Scholar
Bond, G. R., Miller, L. D., Krumwied, R. D., et al (1988) Assertive case management in three CMHCs: a controlled study. Hospital and Community Psychiatry, 39, 411–418.Google ScholarPubMed
Brewin, C. R., Wing, J. K., Magen, S. P., et al (1987) Principles and practice of measuring needs in long term mentally ill: the MRC needs for care assessment. Psychological Medicine, 17, 971–981.Google Scholar
Burns, B. J. & Santos, A. B. (1995) Assertive community treatment: an update of randomised trials. Psychiatric Services, 46, 669–675.Google Scholar
Burns, T. (1997) Case management, care management and care programming. British Journal of Psychiatry, 170, 393–395.CrossRefGoogle ScholarPubMed
Clark, R. E. & Fox, T. S. (1993) A framework for evaluating the economic impact of case management. Hospital and Community Psychiatry, 44, 469–473.Google Scholar
Department of Health (1997) Developing Partnerships in Mental Health. London: HMSO Google Scholar
Holloway, F. (1995) Home treatment as an alternative to acute psychiatric inpatient admission: a discussion. In Community Psychiatry in Action: Analysis and Prospects (eds Tyrer, P. & Creed, F.), pp. 85–96. Cambridge: Cambridge University Press.Google Scholar
Jacobsson, L., von Knorring, L., Mattson, B., et al (1978) The comprehensive psychopathological rating scale (CPRS) in patients with schizophrenic syndromes. Acto Psychiatrica Scandinavica Supplementum, 271, 39–40.Google Scholar
Knapp, M. (1995) Towards an understanding of cost-effectiveness. In Community Psychiatry in Action: Analysis and Prospects (eds Tyrer, P. & Creed, F.), pp. 111–146. Cambridge: Cambridge University Press.Google Scholar
Marshall, M., Gray, A., Lockwood, A., et al (1996) Case management for people with severe mental disorders. In Schizophrenia Module of the Cochrane Database of Systematic Reviews. The Cochrane Collaboration. Issue 3 (eds Adams, C., Anderson, J. & De Jesus Maris, J.). London: BMJ Publishing.Google Scholar
Meitzer, D., Hale, S., Malik, S. J., et al (1991) Community care for patients with schizophrenia one year after hospital discharge. British Medical Journal, 303, 1023–1026.Google Scholar
Merson, S., Tyrer, P., Orryrett, S., et al (1992) Early intervention in psychiatric emergencies: a controlled clinical trial. Lancet, 339, 1311–1314.Google Scholar
Montgomery, S. A. & Åsberg, M. (1979) New depression scale designed to be sensitive to change. British Journal of Psychiatry, 134, 382–389.Google Scholar
Muijen, M., Marks, I., Connolly, J., et al (1992) Home based care and standard hospital care for patients with severe mental illness. British Medical Journal, 304, 749–754.Google ScholarPubMed
Muijen, M., Cooney, M., Strathdee, G., et al (1994) Community psychiatric nurse teams: Intensive support versus generic care. British Journal of Psychiatry, 165, 211–217.Google Scholar
Office of Population Censuses and Surveys (1993) Census 1991: Ethnic Group and Country of Birth: Great Britain. London: HMSO.Google Scholar
Oliver, J. (1991) The quality of life in community care: a consideration of hospital wards prompted by a survey of residential facilities. In Residential Needs for Severely Disabled Psychiatric Patients (ed. Young, R.). London: HMSO.Google Scholar
Rubin, A. (1992) Is case management effective for people with serious mental illness? A research review. Health and Social Work, 17, 138–150.Google Scholar
Ryan, P., Ford, R. & Clifford, P. (1991) Case Management and Community Care. London: Sainsbury Centre for Mental Health.Google Scholar
Sellwood, W. & Tarrier, N. (1994) Demographic factors associated with extreme non-compliance in schizophrenia. Social Psychiatry and Psychiatric Epidemiology, 29, 172–177.Google Scholar
Solomon, P. (1992) The efficacy of case management services for severely mentally disabled clients. Community Mental Health Journal, 28, 163–180.Google Scholar
Spitzer, R. L., Emdicott, J. & Robins, E. (1978) Research diagnostic criteria: rationale and reliability. Archives of General Psychiatry, 35, 773–782.Google Scholar
Thomas, C. S., Stone, K., Osborn, M., et al (1993) Psychiatric morbidity and compulsory admissions among UK-born Europeans. Afro-Caribbeans and Asians in Central Manchester. British Journal of Psychiatry, 163, 91–99.CrossRefGoogle ScholarPubMed
Submit a response

eLetters

No eLetters have been published for this article.