Assessment-based Home Treatment for People with Schizophrenia Spectrum Disorder

Abstract

Introduction

There is a growing evidence for clinical effectiveness of Home Treatment for <a name="OLE_LINK2"></a><a name="OLE_LINK1">patients with severe psychotic disorders</a>. Here we present the development and implementation of a manualised assessment-based Home Treatment in Germany.

Objectives

We compared the 6-month effectiveness of an assessment-based Home Treatment in patients with schizophrenia spectrum disorder to standard care in a catchment area design.

Aims

The primary outcome criteria was the rehospitalisation rate. Secondary outcomes comprised improvement of symptoms, functioning, quality of life, medication adherence and satisfaction with care.

Methods

Assessments were carried out at baseline and at 3 and 6 month. Inpatient admission and treatment contacts were assessed from the hospital database.

Results

We visited 20 patients with severe psychotic disorder (ICD10: F2.x) almost 400 times in twelve months. The median was 15.5 visits per patient. The intervention resulted in a highly significant reduction of the rehospitalisation rate (−51%, P<.01) and we found a significant improvement in Medication Adherence within the first 3 months using the Morisky-Score (P<.01). There wasn´t any significant change in clinical outcome regarding variables from Psychopathology with the Positive and Negative Syndrom Scale (PANNS), Global Assessment of Functioning (GAF), Quality of Life (The World Health Organization Quality of Life, WHO-QUOL) and client satisfaction (ZUF-8).

Conclusions

Applying assessment-based Home Treatment for patients with severe psychotic disorders is an alternative treatment compared with standard care resulting in a significant lower rehospitalisation rate with an equivalent clinical outcome.