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Intensive versus standard case management for severe psychotic illness: a randomised trial. UK 700 Group.

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Title: Intensive versus standard case management for severe psychotic illness: a randomised trial. UK 700 Group.
Authors: Burns T (AUTHOR), Creed F (AUTHOR), Fahy T (AUTHOR), Thompson S (AUTHOR), Tyrer P (AUTHOR), White I (AUTHOR), UK 700 Group (CORPORATE AUTHOR), Burns, T (AUTHOR), Creed, F (AUTHOR), Fahy, T (AUTHOR), Thompson, S (AUTHOR), Tyrer, P (AUTHOR), White, I (AUTHOR)
Source: Lancet. 6/26/1999, Vol. 353 Issue 9171, p2185-2189. 5p.
Abstract: Background: Case management has increasingly been the recommended approach to care for severely mentally ill patients since the number of psychiatric beds has decreased. Despite equivocal results, in the UK and Europe, this approach is becoming accepted policy. We assessed the effect of smaller case loads.Methods: We randomly assigned 708 psychotic patients in four centres standard case management (355 patients, case load 30-35 per case manager) or intensive case management (353 patients, case load 10-15 per case manager). We measured clinical symptoms and social functioning at baseline, 1 year, and 2 years. The impact of treatment on hospital use was assessed at 2 years by subgroup analyses for Afro-Caribbean and for severely socially disabled patients. Analysis was by intention to treat.Findings: There was no significant decline in overall hospital use among intensive-case-management patients (mean 73.5 vs 73.1 days in those who received standard care [SD 0.4, 95% CI -17.4 to 18.1]), nor were there any significant gains in clinical or social functioning. There was no evidence of differential effect in Afro-Caribbean patients or the most socially disabled patients.Interpretation: In well-coordinated mental-health services, a decline in case load alone does not improve outcome for these patients. Mental-health planners may need to pay more attention to the content of treatment rather than changes in service organisation. [ABSTRACT FROM AUTHOR]
Copyright of Lancet is the property of Lancet and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
Database: Psychology and Behavioral Sciences Collection
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  Data: Intensive versus standard case management for severe psychotic illness: a randomised trial. UK 700 Group.
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  Data: <searchLink fieldCode="AR" term="%22Burns+T%22">Burns T</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Creed+F%22">Creed F</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Fahy+T%22">Fahy T</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Thompson+S%22">Thompson S</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Tyrer+P%22">Tyrer P</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22White+I%22">White I</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22UK+700+Group%22">UK 700 Group</searchLink> (CORPORATE AUTHOR)<br /><searchLink fieldCode="AR" term="%22Burns%2C+T%22">Burns, T</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Creed%2C+F%22">Creed, F</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Fahy%2C+T%22">Fahy, T</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Thompson%2C+S%22">Thompson, S</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Tyrer%2C+P%22">Tyrer, P</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22White%2C+I%22">White, I</searchLink> (AUTHOR)
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  Data: <searchLink fieldCode="JN" term="%22Lancet%22">Lancet</searchLink>. 6/26/1999, Vol. 353 Issue 9171, p2185-2189. 5p.
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  Data: <bold>Background: </bold>Case management has increasingly been the recommended approach to care for severely mentally ill patients since the number of psychiatric beds has decreased. Despite equivocal results, in the UK and Europe, this approach is becoming accepted policy. We assessed the effect of smaller case loads.<bold>Methods: </bold>We randomly assigned 708 psychotic patients in four centres standard case management (355 patients, case load 30-35 per case manager) or intensive case management (353 patients, case load 10-15 per case manager). We measured clinical symptoms and social functioning at baseline, 1 year, and 2 years. The impact of treatment on hospital use was assessed at 2 years by subgroup analyses for Afro-Caribbean and for severely socially disabled patients. Analysis was by intention to treat.<bold>Findings: </bold>There was no significant decline in overall hospital use among intensive-case-management patients (mean 73.5 vs 73.1 days in those who received standard care [SD 0.4, 95% CI -17.4 to 18.1]), nor were there any significant gains in clinical or social functioning. There was no evidence of differential effect in Afro-Caribbean patients or the most socially disabled patients.<bold>Interpretation: </bold>In well-coordinated mental-health services, a decline in case load alone does not improve outcome for these patients. Mental-health planners may need to pay more attention to the content of treatment rather than changes in service organisation. [ABSTRACT FROM AUTHOR]
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  Data: <i>Copyright of Lancet is the property of Lancet and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.)
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