RESUMO
AIM: The Integrated Care in Early Psychosis (ACCESS III) Study examined the efficacy and cost-effectiveness of a combined intervention consisting of strategies to improve early detection and quality of care (integrated care including therapeutic assertive community treatment) in adolescents and young adults in the early phase of a severe psychotic disorder from 2011 to 2014. METHODS: This is a prospective, single-centre, 1-year cohort study comparing an intervention condition (early detection plus integrated care, n = 120) to the historical control condition (standard care, SC, n = 105) for adolescents and young adults aged 12-29 years suffering from a severe, early-phase psychotic disorder (i.e. within 2 years of treatment). RESULTS: Primary outcome is the rate of combined symptomatic (i.e. Positive and Negative Syndrome Scale (PANSS) criteria) and functional (i.e. Global Assessment of Functioning scale (GAF) ≥ 60 points criterion) remission over at least 6 months at study endpoint. Secondary outcome comprises the comparison of the reduction in the duration of untreated psychosis within the 4-year study duration between integrated care and SC, course of psychopathology, functioning, quality of life, satisfaction with care, cost and quality-adjusted life years (QALYs) in comparison to a historical control group. CONCLUSION: To the authors' knowledge, this is the first study assessing the efficacy and cost-effectiveness of a combined intervention consisting of early detection strategies and strategies to improve quality of care in both adolescents and young adults with early-phase psychosis. The results will be published in 2016.
Assuntos
Prestação Integrada de Cuidados de Saúde , Diagnóstico Precoce , Intervenção Médica Precoce/métodos , Transtornos Psicóticos/diagnóstico , Transtornos Psicóticos/terapia , Adolescente , Adulto , Criança , Estudos de Coortes , Serviços Comunitários de Saúde Mental , Análise Custo-Benefício , Feminino , Humanos , Masculino , Satisfação do Paciente , Estudos Prospectivos , Transtornos Psicóticos/tratamento farmacológico , Transtornos Psicóticos/psicologia , Qualidade da Assistência à Saúde , Qualidade de Vida , Anos de Vida Ajustados por Qualidade de Vida , Resultado do Tratamento , Adulto JovemRESUMO
This is a prospective 1-year follow-up study comparing a combined intervention consisting of multidimensional early detection strategies with age- and interdisciplinary integrated care (intervention group, nâ=â120) with standard care (historical control group, nâ=â105) in adolescents and young adults within the early phase of psychosis. Data at study entry indicate a high complexity and severity of illness. Primary outcome is the 6-month rate of combined symptomatic and functional remission at study endpoint.