Clinical and cost evaluation of two models of specialist intensive support teams for adults with intellectual disabilities who display behaviours that challenge: the IST-ID mixed-methods study.

Autor: Hassiotis A; Division of Psychiatry, University College London, UK., Kouroupa A; Division of Psychiatry, University College London, UK., Hamza L; Assessment and Intervention Team, Barnet, Enfield and Haringey Mental Health NHS Trust, UK., Marston L; Department of Primary Care and Population Health, University College London, UK., Romeo R; Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK., Yaziji N; Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK., Hall I; Hackney Integrated Learning Disability Service, East London NHS Foundation Trust, UK., Langdon PE; Centre for Educational Development, Appraisal and Research, University of Warwick, UK., Courtenay K; Assessment and Intervention Team, Barnet, Enfield and Haringey Mental Health NHS Trust, UK., Taggart L; Institute of Nursing and Health Research, Ulster University, Northern Ireland., Morant N; Division of Psychiatry, University College London, UK., Crossey V; South West Community Learning Disability Team & Mental Health Intensive Support and Treatment Team, NHS Lothian, UK., Lloyd-Evans B; Division of Psychiatry, University College London, UK.
Jazyk: angličtina
Zdroj: BJPsych open [BJPsych Open] 2023 Jun 26; Vol. 9 (4), pp. e116. Date of Electronic Publication: 2023 Jun 26.
DOI: 10.1192/bjo.2023.74
Abstrakt: Background: Intensive support teams (ISTs) are recommended for individuals with intellectual disabilities who display behaviours that challenge. However, there is currently little evidence about the clinical and cost-effectiveness of IST models operating in England.
Aims: To investigate the clinical and cost-effectiveness of IST models.
Method: We carried out a cohort study to evaluate the clinical and cost-effectiveness of two previously identified IST models (independent and enhanced) in England. Adult participants ( n = 226) from 21 ISTs (ten independent and 11 enhanced) were enrolled. The primary outcome was change in challenging behaviour between baseline and 9 months as measured by the Aberrant Behaviour Checklist-Community version 2.
Results: We found no statistically significant differences between models for the primary outcome (adjusted β = 4.27; 95% CI -6.34 to 14.87; P = 0.430) or any secondary outcomes. Quality-adjusted life-years (0.0158; 95% CI: -0.0088 to 0.0508) and costs (£3409.95; 95% CI -£9957.92 to £4039.89) of the two models were comparable.
Conclusions: The study provides evidence that both models were associated with clinical improvement for similar costs at follow-up. We recommend that the choice of service model should rest with local services. Further research should investigate the critical components of IST care to inform the development of fidelity criteria, and policy makers should consider whether roll out of such teams should be mandated.
Databáze: MEDLINE
Externí odkaz: