Trajectories of patients with severe mental illness in two-year contact with flexible assertive community treatment teams using routine outcome monitoring data
| Autor: | B. Schaefer, Hans E. Kortrijk, Cornelis L. Mulder, Astrid M. Kamperman, Jaap van Weeghel |
|---|---|
| Přispěvatelé: | Geestelijke Gezondheidszorg, Tranzo, Scientific center for care and wellbeing, Psychiatry |
| Jazyk: | angličtina |
| Rok vydání: | 2019 |
| Předmět: |
Adult
Male medicine.medical_specialty Adolescent Assertive community treatment Science Young Adult 03 medical and health sciences NUMBER 0302 clinical medicine SDG 3 - Good Health and Well-being Quality of life PEOPLE QUALITY-OF-LIFE SCALES HONOS SCHIZOPHRENIA medicine Humans CRITERIA Young adult VERSION Aged Aged 80 and over Health Services Needs and Demand Multidisciplinary business.industry Mental Disorders Middle Aged Mental illness medicine.disease Personality disorders Community Mental Health Services Latent class model 030227 psychiatry PREVALENCE Treatment Outcome Latent Class Analysis Physical therapy Medicine Female Observational study CAMBERWELL ASSESSMENT HEALTH business Psychosocial 030217 neurology & neurosurgery |
| Zdroj: | PLoS ONE, Vol 14, Iss 1, p e0207680 (2019) PLOS ONE, 14(1):0207680. PUBLIC LIBRARY SCIENCE PLoS One (online), 14(1):e0207680. Public Library of Science |
| ISSN: | 1932-6203 |
| DOI: | 10.1371/journal.pone.0207680 |
| Popis: | Objective: Using outcome data collected routinely over a continuous two-year treatment period, we wished to distinguish homogeneous subgroups of patients with a severe mental illness whose psychosocial problems followed a similar pattern over time. By identifying the effectiveness of health services for different patient groups, this approach allowed us to identify patients at risk of deterioration and those recovering from their symptoms.Methods: In total we included 2,660 patients who were in two-year continuous contact with a Flexible Assertive Community Treatment team (FACT). We collected outcome data on psychosocial functioning, needs for care and quality of life. We performed a latent class growth analysis (LCGA).Results: The LCGA identified six homogenous patient subgroups using trajectories of HoNOS scores. On the basis of the patterns of patients’ psychosocial problems over time, we labelled these as follows: 1) stable at a low problem-severity level (N = 709; 27%); 2) stable at a low medium problem-severity level (N = 1,208; 45%); 3) stable at a high medium problem-severity level (N = 528; 20%); 4) stable at a high problem-severity level (N = 116; 4%); 5) amelioration of problems (N = 42; 2%); and 6) deterioration of problems (N = 57; 2%). Patients with stable and a high severity of psychosocial problems had more practical and somatic unmet needs than those in other subgroups, and also had the fewest decrease in the number of unmet needs.Discussion: After linking patient subgroups with clinical features such as the need for care, we found that, over two years, most patients remained relatively stable in terms of psychosocial functioning, but that their unmet needs decreased over time. However, in terms of needs for treatment during two years of contact with a FACT team, patients in the subgroup with a stable and high problem-severity level tended to derive little or no benefit. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|