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Predictors of Clinical Outcome of Assertive Community Treatment (ACT) in a Rural Area in Denmark: An Observational Study with a Two-Year Follow-Up

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Abstract

Assertive Community Treatment (ACT) is a multidisciplinary team approach to community care treatment, mainly characterised by small caseload and individualised care. The aim of the present study was to identify predictors of clinical outcome in ACT using an observational design. Three ACT Teams were established in The North Denmark Region to treat patients with severe mental illness. The patients were identified and followed in regional and national psychiatric registers, and in social and somatic case registers, 2 years before and 2 years after inclusion. The results showed that the use of psychiatric hospital services decreased significantly for the 240 included patients. Furthermore, the psychopharmacological profile was improved. No significant change occurred in the consumption of the somatic hospitals. Clinical outcome, defined as halving of admissions or bed days, was in a logistic analysis predicted by the patient’s psychiatric use of inpatient service prior to inclusion in an ACT Team.

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References

  • Aagaard, J., & Muller-Nielsen, K. (2011). Clinical outcome of assertive community treatment (ACT) in a rural area in Denmark: A case–control study with a 2-year follow-up. Nordic Journal of Psychiatry, 65, 299–305.

    Article  PubMed  Google Scholar 

  • Aagaard, J., & Nielsen, J. A. (2004). Experience from the first ACT programme in Denmark. II. Severe mental illness. A register diagnosis. Nordic Journal of Psychiatry, 58, 171–174.

    Article  Google Scholar 

  • Bak, M., Van Os, J., Delespaul, P., de Bie, A., Campo, J., Poddighe, G., et al. (2007). An observational, “real life” trial of the introduction of assertive community treatment in a geographically defined area using clinical rather than service use outcome criteria. Social Psychiatry and Psychiatric Epidemiology, 42, 125–130.

    Article  PubMed  Google Scholar 

  • Bond, G. R., & Drake, R. E. (2007). Should we adopt the Dutch version of ACT? Commentary on “FACT: A Dutch version of ACT”. Community Mental Health Journal, 43, 435–438.

    Article  PubMed  Google Scholar 

  • Brugha, T. S., Taub, N., Smith, J., Morgan, Z., Hill, T., Meltzer, H., et al. (2012). Predicting outcome of assertive outreach across England. Social Psychiatry and Psychiatric Epidemiology, 47, 313–322.

    Article  CAS  PubMed  Google Scholar 

  • Burns, T. (2010). The rise and fall of assertive community treatment? Int. Rev. Psychiatry, 22, 130–137.

    Article  PubMed  Google Scholar 

  • Burns, T., Catty, J., Dash, M., Roberts, C., Lockwood, A., & Marshall, M. (2007). Use of intensive case management to reduce time in hospital in people with severe mental illness: Systematic review and meta-regression. BMJ, 335, 336.

    Article  PubMed  PubMed Central  Google Scholar 

  • Burns, T., Catty, J., Watt, H., Wright, C., Knapp, M., & Henderson, J. (2002). International differences in home treatment for mental health problems. Results of a systematic review. British Journal of Psychiatry, 181, 375–382.

    Article  CAS  PubMed  Google Scholar 

  • Clayton, D., & Hills, M. (1993). Statistical models in epidemiology. Oxford: Science publication.

    Google Scholar 

  • Denmark´s Statistics. (2013). Statistics of all Denmark. Homesite: DST@DST.DK.

    Google Scholar 

  • Drukker, M., Laan, W., Dreef, F., Driessen, G., Smeets, H., & van Os, J. (2014). Can assertive community treatment remedy patients dropping out of treatment due to fragmented services? Community Mental Health Journal, 50, 454–459.

    Article  PubMed  Google Scholar 

  • Hoof, F., Knipsel, A., Scneider, J., Beeley, C., Aagaard, J., Putten, M., et al. (2011). Outpatient care and community support for persons with community support for persons with severe mental health problems. A comparison of national policies and system in Denmark, England and the Netherlands. Utrecht: Trimbos Institute.

    Google Scholar 

  • Issakidis, C., Sanderson, K., Teesson, M., Johnston, S., & Buhrich, N. (1999). Intensive case management in Australia: A randomized controlled trial. Acta Psychiatrica Scandinavica, 99, 360–367.

    Article  CAS  PubMed  Google Scholar 

  • Juel, K., & Helweg-Larsen, K. (1999). The Danish registers of causes of death. Danish Medical Bulletin, 46, 354–357.

    CAS  PubMed  Google Scholar 

  • Killaspy, H., Bebbington, P., Blizard, R., Johnson, S., Nolan, F., Pilling, S., et al. (2006). The REACT study: Randomised evaluation of assertive community treatment in north London. BMJ, 332, 815–820.

    Article  PubMed  PubMed Central  Google Scholar 

  • Kortrijk, H. E., Mulder, C. L., Roosenschoon, B. J., & Wiersma, D. (2010). Treatment outcome in patients receiving assertive community treatment. Community Mental Health Journal, 46, 330–336.

    Article  CAS  PubMed  Google Scholar 

  • Leiphart, L. R., & Barnes, M. G. (2005). The client experience of assertive community treatment: A qualitative study. Psychiatric Rehabilitation Journal, 28, 395–397.

    Article  PubMed  Google Scholar 

  • Marshall, M. & Lockwood, A. (2000). Assertive community treatment for people with severe mental disorders. Oxford: Cochrane Database of Systematic Reviews, CD001089.

  • Marshall, M., & Lockwood, A. (2003). Assertive community treatment for people with severe mental disorders. Oxford: The Cochrane Library.

    Google Scholar 

  • McGrew, J. H., Bond, G. R., Dietzen, L., & Salyers, M. (1994). Measuring the fidelity of implementation of a mental health program model. Journal of Consulting and Clinical Psychology, 62, 670–678.

    Article  CAS  PubMed  Google Scholar 

  • Merinder, L. B. (1999). Impact of patientand relative education on knowledge, satisfaction with services and clinical outcome in schizophrenia. Aarhus: Ph.D Aarhus University.

    Google Scholar 

  • Mors, O., Perto, G. P., & Mortensen, P. B. (2011). The Danish psychiatric central research register. Scandinavian Journal of Public Health, 39, 54–57.

    Article  PubMed  Google Scholar 

  • National Board of Health. (2011). Causes of death register. Data and analyses. Copenhagen: Nationel Board of Health.

    Google Scholar 

  • StataCorp. (2009). Stata statistical software: Release 11. Collage Station, TX: StataCorpLP.

    Google Scholar 

  • Stein, L. I., & Santos, A. B. (1998). Assertive community treatment of persons with severe mental illness. New York: Norten.

    Google Scholar 

  • Sytema, S., Wunderink, L., Bloemers, W., Roorda, L., & Wiersma, D. (2007). Assertive community treatment in the Netherlands: A randomized controlled trial. Acta Psychiatrica Scandinavica, 116, 105–112.

    Article  CAS  PubMed  Google Scholar 

  • Uggerby, P., Ostergaard, S. D., Roge, R., Correll, C. U., & Nielsen, J. (2013). The validity of the schizophrenia diagnosis in the Danish psychiatric central research register is good. Danish Medical Journal, 60, A4578.

    PubMed  Google Scholar 

  • Vendsborg, P. B., Nordentoft, M., Hvenegaard, A., & Søgaard, J. (1999). Opsøgende psykoseteam: Assertive community treatment: A health technology report. DSI Institut for Sundhedsvæsen.

  • World Health Organization. (1992). The ICD-10 classification of mental and behavioral disorders. Clinical descriptions and diagnostic guidelines. Geneva: WHO. (Ref Type: Serial (Book,Monograph)).

    Google Scholar 

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Acknowledgments

The project has been funded by grants from The Ministry of Health and The North Denmark Region. Leslie Foldager, M.Sc. and Ph.D. in statistics, supervised and approved the statistical analyses.

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Authors and Affiliations

  1. Unit for Psychiatric Research and Department S, Psychiatric Hospital, Aalborg University Hospital, Mølleparkvej 10, 9000, Aalborg, Denmark

    Jørgen Aagaard

  2. Unit for Psychiatric Research and Department M, Aarhus University Hospital, Risskov, Skovagervej 2, 8240, Aarhus, Denmark

    Jørgen Aagaard & Pernille Kølbæk

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  1. Jørgen Aagaard
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  2. Pernille Kølbæk
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Correspondence to Jørgen Aagaard.

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Aagaard, J., Kølbæk, P. Predictors of Clinical Outcome of Assertive Community Treatment (ACT) in a Rural Area in Denmark: An Observational Study with a Two-Year Follow-Up. Community Ment Health J 52, 908–913 (2016). https://doi.org/10.1007/s10597-015-9908-y

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