Assessing the efficacy of a modified assertive community-based treatment programme in a developing country

 

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dc.contributor.author Botha, Ulla A en_ZA
dc.contributor.author Koen, Liezl en_ZA
dc.contributor.author Joska, John A en_ZA
dc.contributor.author Hering, Linda M en_ZA
dc.contributor.author Oosthuizen, Piet P en_ZA
dc.date.accessioned 2015-11-11T12:03:32Z
dc.date.available 2015-11-11T12:03:32Z
dc.date.issued 2010 en_ZA
dc.identifier.citation Botha, U. A., Koen, L., Joska, J. A., Hering, L. M., & Oosthuizen, P. P. (2010). Assessing the efficacy of a modified assertive community-based treatment programme in a developing country. BMC psychiatry, 10(1), 73. en_ZA
dc.identifier.uri http://hdl.handle.net/11427/14904
dc.identifier.uri http://dx.doi.org/10.1186/1471-244X-10-73
dc.description.abstract BACKGROUND: A number of recently published randomized controlled trials conducted in developed countries have reported no advantage for assertive interventions over standard care models. One possible explanation could be that so-called "standard care" has become more comprehensive in recent years, incorporating some of the salient aspects of assertive models in its modus operandi. Our study represents the first randomised controlled trial assessing the effect of a modified assertive treatment service on readmission rates and other measures of outcome in a developing country. METHODS: High frequency service users were randomized into an intervention (n = 34) and a control (n = 26) group. The control group received standard community care and the active group an assertive intervention based on a modified version of the international model of assertive community treatment. Study visits were conducted at baseline and 12 months with demographic and illness information collected at visit 1 and readmission rates documented at study end. Symptomatology and functioning were measured at both visits using the PANSS, CDSS, ESRS, WHO-QOL and SOFAS. RESULTS: At 12 month follow-up subjects receiving the assertive intervention had significantly lower total PANSS (p = 0.02) as well as positive (p < 0.01) and general psychopathology (p = 0.01) subscales' scores. The mean SOFAS score was also significantly higher (p = 0.02) and the mean number of psychiatric admissions significantly lower (p < 0.01) in the intervention group. CONCLUSIONS: Our results indicate that assertive interventions in a developing setting where standard community mental services are often under resourced can produce significant outcomes. Furthermore, these interventions need not be as expensive and comprehensive as international, first-world models in order to reduce inpatient days, improve psychopathology and overall levels of functioning in patients with severe mental illness. en_ZA
dc.language.iso eng en_ZA
dc.publisher BioMed Central Ltd en_ZA
dc.rights This is an Open Access article distributed under the terms of the Creative Commons Attribution License en_ZA
dc.rights.uri http://creativecommons.org/licenses/by/2.0 en_ZA
dc.source BMC Psychiatry en_ZA
dc.source.uri http://www.biomedcentral.com/bmcpsychiatry/ en_ZA
dc.subject.other Primary Health Care Institution en_ZA
dc.subject.other Assertive Community Treatment en_ZA
dc.subject.other Occupational Therapy Assessment en_ZA
dc.subject.other State Psychiatric Hospital en_ZA
dc.subject.other Depot Medication en_ZA
dc.subject.other Severe Mental Illness en_ZA
dc.subject.other Sofa Score en_ZA
dc.subject.other PANSS Total Score en_ZA
dc.subject.other ESR en_ZA
dc.title Assessing the efficacy of a modified assertive community-based treatment programme in a developing country en_ZA
dc.type Journal Article en_ZA
dc.rights.holder 2010 Botha et al; licensee BioMed Central Ltd. en_ZA
uct.type.publication Research en_ZA
uct.type.resource Article en_ZA
dc.publisher.institution University of Cape Town
dc.publisher.faculty Faculty of Health Sciences en_ZA
dc.publisher.department Department of Psychiatry and Mental Health en_ZA
uct.type.filetype Text
uct.type.filetype Image
dc.identifier.apacitation Botha, U. A., Koen, L., Joska, J. A., Hering, L. M., & Oosthuizen, P. P. (2010). Assessing the efficacy of a modified assertive community-based treatment programme in a developing country. <i>BMC Psychiatry</i>, http://hdl.handle.net/11427/14904 en_ZA
dc.identifier.chicagocitation Botha, Ulla A, Liezl Koen, John A Joska, Linda M Hering, and Piet P Oosthuizen "Assessing the efficacy of a modified assertive community-based treatment programme in a developing country." <i>BMC Psychiatry</i> (2010) http://hdl.handle.net/11427/14904 en_ZA
dc.identifier.vancouvercitation Botha UA, Koen L, Joska JA, Hering LM, Oosthuizen PP. Assessing the efficacy of a modified assertive community-based treatment programme in a developing country. BMC Psychiatry. 2010; http://hdl.handle.net/11427/14904. en_ZA
dc.identifier.ris TY - Journal Article AU - Botha, Ulla A AU - Koen, Liezl AU - Joska, John A AU - Hering, Linda M AU - Oosthuizen, Piet P AB - BACKGROUND: A number of recently published randomized controlled trials conducted in developed countries have reported no advantage for assertive interventions over standard care models. One possible explanation could be that so-called "standard care" has become more comprehensive in recent years, incorporating some of the salient aspects of assertive models in its modus operandi. Our study represents the first randomised controlled trial assessing the effect of a modified assertive treatment service on readmission rates and other measures of outcome in a developing country. METHODS: High frequency service users were randomized into an intervention (n = 34) and a control (n = 26) group. The control group received standard community care and the active group an assertive intervention based on a modified version of the international model of assertive community treatment. Study visits were conducted at baseline and 12 months with demographic and illness information collected at visit 1 and readmission rates documented at study end. Symptomatology and functioning were measured at both visits using the PANSS, CDSS, ESRS, WHO-QOL and SOFAS. RESULTS: At 12 month follow-up subjects receiving the assertive intervention had significantly lower total PANSS (p = 0.02) as well as positive (p < 0.01) and general psychopathology (p = 0.01) subscales' scores. The mean SOFAS score was also significantly higher (p = 0.02) and the mean number of psychiatric admissions significantly lower (p < 0.01) in the intervention group. CONCLUSIONS: Our results indicate that assertive interventions in a developing setting where standard community mental services are often under resourced can produce significant outcomes. Furthermore, these interventions need not be as expensive and comprehensive as international, first-world models in order to reduce inpatient days, improve psychopathology and overall levels of functioning in patients with severe mental illness. DA - 2010 DB - OpenUCT DO - 10.1186/1471-244X-10-73 DP - University of Cape Town J1 - BMC Psychiatry LK - https://open.uct.ac.za PB - University of Cape Town PY - 2010 T1 - Assessing the efficacy of a modified assertive community-based treatment programme in a developing country TI - Assessing the efficacy of a modified assertive community-based treatment programme in a developing country UR - http://hdl.handle.net/11427/14904 ER - en_ZA


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This is an Open Access article distributed under the terms of the Creative Commons Attribution License Except where otherwise noted, this item's license is described as This is an Open Access article distributed under the terms of the Creative Commons Attribution License