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Treatment adherence of a case managed program for patients with severe schizophrenia compared to standard care in mental health units.

INTRODUCTION: Although some studies have reported that case management (CM), when is compared with standard care, reduces the loss of contact with health services, the debate continues about its superiority over other treatment models. OBJECTIVES: To assess treatment adherence and reasons for treatm...

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Autores principales: Díaz-Fernández, S., Fernández-Miranda, J. J., López-Muñoz, F.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Cambridge University Press 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10417863/
http://dx.doi.org/10.1192/j.eurpsy.2023.2312
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author Díaz-Fernández, S.
Fernández-Miranda, J. J.
López-Muñoz, F.
author_facet Díaz-Fernández, S.
Fernández-Miranda, J. J.
López-Muñoz, F.
author_sort Díaz-Fernández, S.
collection PubMed
description INTRODUCTION: Although some studies have reported that case management (CM), when is compared with standard care, reduces the loss of contact with health services, the debate continues about its superiority over other treatment models. OBJECTIVES: To assess treatment adherence and reasons for treatment discontinuation, and the impact of the type of APs administration on it, for a group of patients with schizophrenia treated in a CMP or receiving standard treatment in mental health units (MHUs). METHODS: An observational, longitudinal study (ten-year follow-up) was conducted on 688 patients with severe schizophrenia (CGI-S ≥ 5). All the causes of the end of treatment were recorded, together with the AP medication prescribed and kind of regimes. RESULTS: 43.6% of the patients had discontinued treatment in MHUs and only 12.1% on the CMP (p < 0.0001). 27.6% of patients in MHUs were on long-acting injectables (LAIs), and 57.6 on the CMP (p < 0.001). Treatment discontinuation was closely linked to be on OAPs medication in both cases (p < 0.001). [Table: see text] CONCLUSIONS: Our findings show how specific strategies as programs with an integrated treatment and case-managed approach, increase adherence. Moreover, treating with LAI APs clearly contributes to the achievement of these results. The widespread implementation of comprehensive community programs with case management, and the use of LAI-APs, should be an effective choice for people with schizophrenia and clinical severity and impairment, and at high risk of treatment discontinuation. DISCLOSURE OF INTEREST: None Declared
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spelling pubmed-104178632023-08-12 Treatment adherence of a case managed program for patients with severe schizophrenia compared to standard care in mental health units. Díaz-Fernández, S. Fernández-Miranda, J. J. López-Muñoz, F. Eur Psychiatry Abstract INTRODUCTION: Although some studies have reported that case management (CM), when is compared with standard care, reduces the loss of contact with health services, the debate continues about its superiority over other treatment models. OBJECTIVES: To assess treatment adherence and reasons for treatment discontinuation, and the impact of the type of APs administration on it, for a group of patients with schizophrenia treated in a CMP or receiving standard treatment in mental health units (MHUs). METHODS: An observational, longitudinal study (ten-year follow-up) was conducted on 688 patients with severe schizophrenia (CGI-S ≥ 5). All the causes of the end of treatment were recorded, together with the AP medication prescribed and kind of regimes. RESULTS: 43.6% of the patients had discontinued treatment in MHUs and only 12.1% on the CMP (p < 0.0001). 27.6% of patients in MHUs were on long-acting injectables (LAIs), and 57.6 on the CMP (p < 0.001). Treatment discontinuation was closely linked to be on OAPs medication in both cases (p < 0.001). [Table: see text] CONCLUSIONS: Our findings show how specific strategies as programs with an integrated treatment and case-managed approach, increase adherence. Moreover, treating with LAI APs clearly contributes to the achievement of these results. The widespread implementation of comprehensive community programs with case management, and the use of LAI-APs, should be an effective choice for people with schizophrenia and clinical severity and impairment, and at high risk of treatment discontinuation. DISCLOSURE OF INTEREST: None Declared Cambridge University Press 2023-07-19 /pmc/articles/PMC10417863/ http://dx.doi.org/10.1192/j.eurpsy.2023.2312 Text en © The Author(s) 2023 https://creativecommons.org/licenses/by/4.0/This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Abstract
Díaz-Fernández, S.
Fernández-Miranda, J. J.
López-Muñoz, F.
Treatment adherence of a case managed program for patients with severe schizophrenia compared to standard care in mental health units.
title Treatment adherence of a case managed program for patients with severe schizophrenia compared to standard care in mental health units.
title_full Treatment adherence of a case managed program for patients with severe schizophrenia compared to standard care in mental health units.
title_fullStr Treatment adherence of a case managed program for patients with severe schizophrenia compared to standard care in mental health units.
title_full_unstemmed Treatment adherence of a case managed program for patients with severe schizophrenia compared to standard care in mental health units.
title_short Treatment adherence of a case managed program for patients with severe schizophrenia compared to standard care in mental health units.
title_sort treatment adherence of a case managed program for patients with severe schizophrenia compared to standard care in mental health units.
topic Abstract
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10417863/
http://dx.doi.org/10.1192/j.eurpsy.2023.2312
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