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Schizophrenia Outcomes Better With Case-Managed Care in the Community
Patients with severe schizophrenia treated in a community-based, case-managed program had a higher rate of treatment retention, fewer hospital admissions and suicide attempts, and less clinical severity compared with those who received standard treatment in mental health units, according to a study published in the Journal of Psychiatric Practice.
“Treatment with long-acting antipsychotics was also clearly related to these outcomes,” added researchers, who were based in Spain.
The observational, prospective, 10-year study included 688 patients with severe schizophrenia. Researchers looked at outcomes, as well as treatment approaches associated with gains, among patients receiving standard schizophrenia treatment in mental health units compared with patients in a case-managed program in the community.
In Stable Schizophrenia, Lower Antipsychotic Doses Offer Efficacy for Relapse Prevention
According to the study, hospital admissions and suicide attempts were significantly lower among patients in the community-based, case-managed program than among those in mental health units offering standard care. Clinical severity scale scores also decreased significantly more with the community-based, case-managed program than with mental health unit care.
The use of long-acting injectable antipsychotic medication was closely linked with higher treatment retention as well as with lower rates of hospital admission and suicide attempt compared with oral antipsychotics no matter where patients received treatment. The effect of long-acting injectables, however, was stronger in the community-based setting than in mental health units, researchers reported.
“A combination of intensive case-managed integrated treatment and treatment with long-acting antipsychotic medication facilitated the achievement of clinical and rehabilitation goals in patients with schizophrenia with severe symptoms and impairment compared with standard care and treatment with oral antipsychotics,” they concluded.
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