Substance Use Disorders
Conditions
Brief summary
Home Treatment (HT) has been successfully implemented in adult psychiatry in several countries including Switzerland. Patients with addiction problems were generally excluded even if the latter was not the main diagnosis. On the other hand, community treatments have successfully been established for these individuals. The investigators have recently offered HT to persons with severe addictive disorders which was well accepted. The investigators intend to conduct a pilot study to prepare a large-scale study if successful. The investigators intend to compare HT to treatment as usual (regular inpatient treatment) on a specialized ward with respect to readmission rates during 6 months after discharge. The data show that 70.8% of all readmissions occur during the first 6 months. Therefore, a period of 6 months is considered an adequate time interval to sufficiently answer this pilot study's question.
Interventions
OTHERHospital-like treatment in patients' home
Hospital-like treatment in patients' home. Caregivers, medical doctors and social workers will make several visits per day to the patients' home. 24/7 contact is available.
OTHERstandard inpatient treatment
Inpatient treatment on addiction ward
Sponsors
Louise Penzenstadler
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE
Intervention model description
Pilot study, randomized, open, non-blinded
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Substance use disorder * age 18 or above * sufficient french language skills * competent subjects * consent to randomization progress
Exclusion criteria
* organic brain disease or developmental disorder * non voluntary admission * severe somatic comorbidity * History of complicated substance withdrawal * acute suicidal ideation * aggressive behavior * acute psychiatric disease such as mania or psychosis * distance to center (must be reachable within 60 minutes)
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| readmission rates | 6 month post-discharge | Number of readmissions to hospital during the 6 months following discharge |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| time to readmission | 6 months | Number of days between discharge and readmission during the 6 months following discharge |
| length of hospitalization | 6 months | total number of days spent in hospital during the 6 months following discharge |
| number of emergency room visits | 6 months | number of emergency room visits during the 6 months following discharge |
| clinical outcome | 6 months | clinical outcomes measured with Health of the Nation Outcome scale (HoNOS) scoring 0 (no symptoms) to 48 (high symptom level) and the Brief Symptom Check-List (short form of the Brief Symptom Inventory), scoring 0-53 items (higher score = more symptoms). Measured at the start and end of intervention/hospital treatment. |
| patient satisfaction | 6 months | Patient satisfaction measured with the S-ANQ (https://www.anq.ch/en/), a questionnaire used by all Swiss hospitals to measure patient satisfaction with treatment. The questionnaire includes 6 questions which are marked from 0 not at all satisfied to 5 = very satisfied. Scoring 0 (not at all satisfied) to 30 (very satisfied) |
Countries
Switzerland
Contacts
Primary ContactLouise Penzenstadler, MD
Outcome results
None listed