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Paper Description


Evaluation of community psychiatric - home visit treatment versus outpatient treatment of chronic schizophrenic patients in Bahrain


Authors: Hussain HAA, Tarada M, Redha M, Sequeira RP
Abstract: Background: Schizophrenia has a high rate of relapse. Treatment compliance is challenging in the long-term management of schizophrenia. The outcomes of previous studies on Community Psychiatry Service – Home Visit Treatment (CPS-HVT) are inconclusive.
Aims: To evaluate the effectiveness of CPS-HVT in (a) reducing the number of admissions and (b) duration of admissions of chronic schizophrenic patients.
Methods: A retrospective analysis by auditing files of all cases of adult schizophrenic patients in Bahrain who underwent CPS-HVT treatment. A total of 10 years follow-up (5 years of outpatient treatment before the referral to the community service and 5 years follow-up in the community service after the referral) was carried out. The number of admissions and the duration of admissions were compared.
Results: Of the total number of 232 patients 51 (22%) fulfilled the inclusion criteria. The sum total of 77 admissions during 5 years before the referral to the CPS-HVT was 2577 days (50.5 d/patient). After the referral to the CPS-HVT the sum total of 48 admissions was 1383 days (27.1 d/patient), and no patient had more than 3 admissions. The number of non-hospitalized patients doubled during the 5 years follow-up in the CPS-HVT (n=13; 4 males vs. n=27; 10 males). The proportion of males was 47.1% (n=24).
Conclusions: CPS-HVT is effective and superior to standard outpatient treatment of chronic schizophrenic patients in reducing the number and duration of admissions, in Bahrain. Future studies should evaluate a wide range of other outcomes, including the cost effectiveness of CPS-HVT. Considering the massive impact of community-based care on patients, caregivers, clinicians and the community at large, such studies are urgently needed.
Published in: Arab Journal of Psychiatry ;(20):34-41
URL: http://www.arabjpsychiat.com/media/PDF/2009_m/07.pdf
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