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Evaluation of Home Treatment for Acute Psychiatric Care

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ClinicalTrials.gov Identifier: NCT03320720
Recruitment Status : Not yet recruiting
First Posted : October 25, 2017
Last Update Posted : October 25, 2017
Sponsor:
Information provided by (Responsible Party):
Matthias Jäger, Psychiatric University Hospital, Zurich

Brief Summary:
The study's goal is to evaluate whether home treatment is an effective and efficient alternative to inpatient care for people with acute mental illness. Patients who meet the study's inclusion criteria are randomly assigned to either the condition home treatment or inpatient care (treatment-as-usual), during one year. Following two years, the two treatment modalities will be analyzed in terms of inpatient days, cost effectiveness, rehospitalization rate, severity of symptoms and sociodemographics.

Condition or disease Intervention/treatment Phase
Mental Disorder Other: Home Treatment Other: Treatment-as-usual Not Applicable

Detailed Description:
The study's goal is to evaluate whether home treatment is an effective and efficient alternative to inpatient care for people with acute mental illness. Therefore, psychiatric patients in need of hospitalization who meet the study's inclusion criteria are randomly assigned to either the condition home treatment or inpatient care (treatment-as-usual) during one year. Home treatment patients are visited by a mobile and multiprofessional care team at their homes. Additionally, patients without a health insurance for home treatment and patients who are directly assigned to home treatment are included in separate study groups. Following two years, it will be checked whether home treatment leads to a reduction of inpatient days as a primary outcome. Further outcomes such as cost effectiveness, rehospitalization rate, severity of symptoms and sociodemographics will be also analyzed.

Study Type : Interventional  (Clinical Trial)
Estimated Enrollment : 700 participants
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)
Primary Purpose: Health Services Research
Official Title: Evaluation of Home Treatment for Acute Psychiatric Care of the Psychiatric University Hospital Zurich (Switzerland)
Estimated Study Start Date : November 2017
Estimated Primary Completion Date : November 2020
Estimated Study Completion Date : November 2020

Resource links provided by the National Library of Medicine

MedlinePlus related topics: Mental Disorders

Arm Intervention/treatment
Experimental: Home Treatment
Patients with acute mental illness are treated at their houses by a mobile and multiprofessional care team instead of being treated as inpatients if their medical condition permits.
Other: Home Treatment
Patients with acute mental illness in need of inpatient care are treated at their houses by a mobile and multiprofessional care team if their health condition permits.

Active Comparator: Treatment-as-usual
Patients with acute mental illness are treated as inpatients in a psychiatric clinic.
Other: Treatment-as-usual
Patients with acute mental illness in need of inpatient care are treated in a psychiatric clinic.




Primary Outcome Measures :
  1. Inpatient days [ Time Frame: 2 years follow-up ]
    Number of inpatient days per patient


Secondary Outcome Measures :
  1. Total days in treatment [ Time Frame: 2 years follow-up ]
    Total days in Treatment per patient = inpatient and home treatment

  2. Treatment costs [ Time Frame: 2 years follow-up ]
    Calculated direct treatment costs

  3. Rehospitalization rate [ Time Frame: 2 years follow-up ]
    Number of rehospitalizations per patient and duration until rehospitalization

  4. Adverse events [ Time Frame: 2 years follow-up ]
    e.g. suicide or attempted suicide

  5. Global Assessment of Functioning Scale (GAF) [ Time Frame: 2 years follow-up ]
    Scale measures social, occupational and psychological functioning and ranges from 0 to 100 (higher values mean better outcome).

  6. Health of the Nation Outcome Scale (HoNOS) [ Time Frame: 2 years follow-up ]
    Scale measures the severity of symptoms and ranges from 0 to 48 (higher values mean worse outcome).

  7. Clinical Global Impression Scale (CGI) [ Time Frame: 2 years follow-up ]
    Scale measures the severity of symptoms, global improvement and therapeutic response and ranges from 0 to 7 (higher values mean worse outcome).

  8. Patients' satisfaction [ Time Frame: 2 years follow-up ]
    Patients' satisfaction assessed by the official questionnaire of the national association of the quality development in hospitals (ANQ)



Information from the National Library of Medicine

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Ages Eligible for Study:   18 Years to 65 Years   (Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  • Need for acute psychiatric inpatient care
  • Residence in Zurich city
  • Health insurance for Home Treatment

Exclusion Criteria:


Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT03320720


Contacts
Contact: Matthias Jäger, MD 0041 44 384 26 37 matthias.jaeger@puk.zh.ch
Contact: Sonja Mötteli, PhD 0041 44 384 34 41 sonja.moetteli@puk.zh.ch

Locations
Switzerland
Psychiatric University Hospital Zurich Not yet recruiting
Zürich, Zurich, Switzerland, 8032
Contact: Matthias Jäger, MD    0041 44 384 26 37    matthias.jaeger@puk.zh.ch   
Contact: , PhD    0041 44 384 34 41    matthias.jaeger@puk.zh.ch   
Sponsors and Collaborators
Psychiatric University Hospital, Zurich
Investigators
Principal Investigator: Matthias Jäger, MD Psychiatric University Hospital, Zurich

Responsible Party: Matthias Jäger, PD Dr. med., Psychiatric University Hospital, Zurich
ClinicalTrials.gov Identifier: NCT03320720     History of Changes
Other Study ID Numbers: HT201701349
First Posted: October 25, 2017    Key Record Dates
Last Update Posted: October 25, 2017
Last Verified: October 2017
Individual Participant Data (IPD) Sharing Statement:
Plan to Share IPD: No

Studies a U.S. FDA-regulated Drug Product: No
Studies a U.S. FDA-regulated Device Product: No

Additional relevant MeSH terms:
Mental Disorders
Psychotic Disorders
Schizophrenia Spectrum and Other Psychotic Disorders