Home-Based Care and Standard Hospital Care for Patients with Severe Mental Illness: A Randomised Controlled Trial

1993 ◽  
Vol 162 (2) ◽  
pp. 239-243 ◽  
Author(s):  
C. J. Simpson ◽  
C. P. Seager ◽  
J. A. Robertson
Keyword(s):  
Mental Illness ◽  
Randomised Controlled Trial ◽  
Home Care ◽  
Daily Living ◽  
Hospital Care ◽  
Controlled Trial ◽  
Home Based ◽  
Randomised Controlled ◽  
Home Based Care ◽  
Hospital Group

ObjectiveTo compare the efficacy of home based care with standard hospital care in treating serious mental illness.DesignRandomised controlled trial.SettingSouth Southwark, London.Patients189 patients aged 18–64 living in catchment area. 92 were randomised to home based care (daily living programme) and 97 to standard hospital care. At three months' follow up 68 home care and 60 hospital patients were evaluated.Main outcome measuresUse of hospital beds, psychiatric diagnosis, social functioning, patients' and relatives' satisfaction, and activity of daily living programme staff.ResultsHome care reduced hospital stay by 80% (median stay 6 days in home care group, 53 days in hospital group) and did not increase the number of admissions compared with hospital care. On clinical and social outcome there was a non–significant trend in favour of home care, but both groups showed big improvements. On the global adjustment scale home care patients improved by 26.8 points and the hospital group by 21.6 points (difference 5.2; 95% confidence interval -1.5 to 12). Other rating scales showed similar trends. Home care patients required a wide range of support in areas such as housing, finance, and work. Only three patients dropped out from the programme.ConclusionsHome based care may offer some slight advantages over hospital based care for patients with serious mental illness and their relatives. The care is intensive, but the low drop out rate suggests appreciation. Changes to traditional training for mental health workers are required.

scholarly journals Randomised controlled trial comparing hospital at home care with inpatient hospital care. I: three month follow up of health outcomes

BMJ ◽  
1998 ◽  
Vol 316 (7147) ◽  
pp. 1786-1791 ◽  
Author(s):  
S. Shepperd ◽  
D. Harwood ◽  
C. Jenkinson ◽  
A. Gray ◽  
M. Vessey ◽  
...  
Keyword(s):  
Randomised Controlled Trial ◽  
Home Care ◽  
Health Outcomes ◽  
Hospital Care ◽  
Controlled Trial ◽  
Inpatient Hospital ◽  
Hospital At Home ◽  
Randomised Controlled ◽  
At Home

Service use and Costs of Home-Based Versus Hospital-Based Care for People with Serious Mental Illness

1994 ◽  
Vol 165 (2) ◽  
pp. 195-203 ◽  
Author(s):  
M. Knapp ◽  
J. Beecham ◽  
V. Koutsogeorgopoulou ◽  
A. Hallam ◽  
A. Fenyo ◽  
...  
Keyword(s):  
Mental Illness ◽  
Service Use ◽  
Controlled Trial ◽  
Cost Savings ◽  
Emergency Admission ◽  
Cost Effective ◽  
Medium Term ◽  
Home Based ◽  
Randomised Controlled ◽  
Home Based Care

Background.The Daily Living Programme (DLP) offered problem-oriented, home-based care for people aged 17–64 with severe mental illness facing emergency admission to the Bethlem–Maudsley Hospital. The multidisciplinary DLP team acted as direct provider and link with other services. Each patient had a key worker. Cost-effectiveness was assessed.Method.The comprehensive costs of DLP and standard in-patient care were compared within a randomised controlled trial. Cost measures ranged over all service inputs and living expenses. The costs of informal care and lost employment were also considered. Assessments of service use, costs and outcomes were conducted at referral, 4, 11 and 20 months.Results.The DLP was significantly less costly than standard treatment in both short and medium term (P = 0.000). Cost savings accrued almost exclusively to the NHS, with no other agency's costs being higher.Conclusions.Coupled with mildly encouraging outcome results over the 20 month period, the DLP was clearly cost-effective in this medium term.

scholarly journals Supported progressive resistance exercise training to counter the adverse side effects of robot-assisted radical prostatectomy: a randomised controlled trial

2021 ◽  
Author(s):  
Ruth E. Ashton ◽  
Jonathan J. Aning ◽  
Garry A. Tew ◽  
Wendy A Robson ◽  
John M Saxton
Keyword(s):  
Randomised Controlled Trial ◽  
Radical Prostatectomy ◽  
Muscular Strength ◽  
Controlled Trial ◽  
Control Group ◽  
Robot Assisted ◽  
Resistance Exercise Training ◽  
Home Based ◽  
Aerobic Exercise Capacity ◽  
Randomised Controlled

Abstract Purpose To investigate the effects of a supported home-based progressive resistance exercise training (RET) programme on indices of cardiovascular health, muscular strength and health-related quality of life (HR-QoL) in prostate cancer (PCa) patients after treatment with robot-assisted radical prostatectomy (RARP). Methods This study was a single-site, two-arm randomised controlled trial, with 40 participants randomised to either the intervention or control group over a 10-month period. In addition to receiving usual care, the intervention group completed three weekly RET sessions using resistance bands for 6 months. Participants performed 3 sets of 12–15 repetitions for each exercise, targeting each major muscle group. The control group received usual care only. Brachial artery flow-mediated dilatation (FMD) was the primary outcome and assessed at baseline, 3 and 6 months. Secondary outcomes included body weight, body fat, aerobic fitness, strength and blood-borne biomarkers associated with cardiometabolic risk. Results There was no significant difference between the groups in FMD at 3 or 6 months. However, there were improvements in aerobic exercise capacity (P < 0.01) and upper- (P < 0.01) and lower-limb (P = 0.01) strength in favour of the RET group at 6 months, accompanied by greater weight loss (P = 0.04) and a reduction in body fat (P = 0.02). Improvements in HRQoL were evident in the RET group at 3 and 6 months via the PCa-specific component of the FACT-P questionnaire (both P < 0.01). Five adverse events and one serious adverse event were reported throughout the trial duration. Conclusion This study demonstrates that home-based RET is an effective and safe mode of exercise that elicits beneficial effects on aerobic exercise capacity, muscular strength and HR-QoL in men who have undergone RARP. Trial registration ISRCTN10490647.

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