A Change of Paradigm in the Management of Acute Psychiatric Episodes? A Retrospective Cohort Study on Trajectories of Use of Clinical Resources After the Implementation of Intensive Home-Treatment

Intensive home treatment (IHT) has shown to be a feasible alternative to hospitalization for the management of acute psychiatric episodes, but there are no real-world studies assessing if patients with a first IHT use it again for the management of their recurrences. The objectives of this retrospec...

Full description

Saved in:
Bibliographic Details
Published in:Community mental health journal 2024-02, Vol.60 (5), p.1025-1030
Main Authors: Martín-Blanco, Ana, González-Fernández, Alba, Farré, Adriana, Sagué-Vilavella, Maria, Vieira, Sara, Giménez, David, Alvaro, Patricia, Isern, Clara, Torres, Cristina, de la Cruz, Vicente, Martín, Carlos, Moll, Núria, Portella, Maria Jesús
Format: Article
Language:English
Subjects:
Brief Report
Cohort analysis
Community and Environmental Psychology
Home based treatment
Hospitalization
Indexes
Management
Medicine
Medicine & Public Health
Mental disorders
Patient admissions
Patients
Psychiatry
Psychosis
Citations: Items that this one cites
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Intensive home treatment (IHT) has shown to be a feasible alternative to hospitalization for the management of acute psychiatric episodes, but there are no real-world studies assessing if patients with a first IHT use it again for the management of their recurrences. The objectives of this retrospective cohort study were to map the use ofacute treatment resources after the implementation of IHT in our territory through the establishment of trajectories of management, and to disentangle if there are profiles of patients who fit better each trajectory. We included the first 1000 episodes admitted to IHT, of which we selected those that corresponded to the first IHT of a patient (index admission). Trajectories after the index admission were: (T-A) absence of use of acute resources, (T-B) only IHT, and (T-C) at least one hospitalization. Follow-up ranged from 6 months to 6 years. We calculated the frequency of each trajectory and performed univariate analyses searching for associations between trajectory and clinical factors. Among those patients with psychiatric history (N = 659), 66.2% followedT-A, 11.2% T-B, and 22.6% T-C. The probability of following T-C was higher for patients with a psychotic disorder (p Bonf  = 0.018) and with previous hospitalizations (p Bonf  
ISSN:0010-3853
1573-2789
DOI:10.1007/s10597-024-01236-z