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Báo cáo y học: " Assessing the efficacy of a modified assertive community-based treatment programme in a developing country"

Tuyển tập báo cáo các nghiên cứu khoa học quốc tế ngành y học dành cho các bạn tham khảo đề tài: Assessing the efficacy of a modified assertive community-based treatment programme in a developing country | Botha et al. BMC Psychiatry 2010 10 73 http www.biomedcentral.com 1471-244X 10 73 BMC Psychiatry RESEARCH ARTICLE Open Access Assessing the efficacy of a modified assertive community-based treatment programme in a developing country Ulla A Botha1 Liezl Koen John A Joska2 Linda M Hering3 Piet P Oosthuizen1 Abstract Background A number of recently published randomized controlled trials conducted in developed countries have reported no advantage for assertive interventions over standard care models. One possible explanation could be that so-called standard care has become more comprehensive in recent years incorporating some of the salient aspects of assertive models in its modus operandi. Our study represents the first randomised controlled trial assessing the effect of a modified assertive treatment service on readmission rates and other measures of outcome in a developing country. Methods High frequency service users were randomized into an intervention n 34 and a control n 26 group. The control group received standard community care and the active group an assertive intervention based on a modified version of the international model of assertive community treatment. Study visits were conducted at baseline and 12 months with demographic and illness information collected at visit 1 and readmission rates documented at study end. Symptomatology and functioning were measured at both visits using the PANSS CDSS ESRS WHO-QOL and SOFAS. Results At 12 month follow-up subjects receiving the assertive intervention had significantly lower total PANSS p 0.02 as well as positive p 0.01 and general psychopathology p 0.01 subscales scores. The mean SOFAS score was also significantly higher p 0.02 and the mean number of psychiatric admissions significantly lower p 0.01 in the intervention group. Conclusions Our results indicate that assertive interventions in a developing setting where standard community mental services are often under resourced can produce significant outcomes. .