Effectiveness of integrated care including therapeutic assertive community treatment in severe schizophrenia-spectrum and bipolar I disorders: Four-year follow-up of the ACCESS II study

PloS One
Daniel SchöttleMartin Lambert

Abstract

The ACCESS-model offers integrated care including assertive community treatment to patients with psychotic disorders. ACCESS proved more effective compared to standard care (ACCESS-I study) and was successfully implemented into clinical routine (ACCESS-II study). In this article, we report the 4-year outcomes of the ACCESS-II study. Between May 2007 and December 2013, 115 patients received continuous ACCESS-care. We hypothesized that the low 2-year disengagement and hospitalization rates and significant improvements in psychopathology, functioning, and quality of life could be sustained over 4 years. Over 4 years, only 10 patients disengaged from ACCESS. Another 23 left for practical reasons and were successfully transferred to other services. Hospitalization rates remained low (13.0% in year 3; 9.1% in year 4). Involuntary admissions decreased from 35% in the 2 years prior to ACCESS to 8% over 4 years in ACCESS. Outpatient contacts remained stably high at 2.0-2.4 per week. We detected significant improvements in psychopathology (effect size d = 0.79), illness severity (d = 1.29), level of functioning (d = 0.77), quality of life (d = 0.47) and stably high client satisfaction (d = 0.02) over 4 years. Most positive effects were o...Continue Reading

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Citations

Jul 11, 2019·Community Mental Health Journal·Eva GuérinDenis Prud'homme
Sep 5, 2019·Der Nervenarzt·Martin LambertJürgen Gallinat
Jan 10, 2019·Bundesgesundheitsblatt, Gesundheitsforschung, Gesundheitsschutz·Martin LambertAnne Karow
May 17, 2018·Frontiers in Psychiatry·Alexandre WullschlegerChristiane Montag
Jul 20, 2019·Social Psychiatry and Psychiatric Epidemiology·Siobhan ReynoldsBrian O'Donoghue
Oct 12, 2020·Australian Journal of Primary Health·Renee O DonnellHelen Skouteris
Jan 14, 2021·Journal of Psychiatric Practice·Lauren E ReevesBrandon A Gaudiano

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Clinical Trials Mentioned

NCT01888627

Software Mentioned

SPSS
II
ACCESS

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