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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.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Home treatment | Experimental | Home visits by care staff at the same frequency as in hospital |
|
| Standard inpatient treatment | Active Comparator | Inpatient treatment on hospital ward |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Hospital-like treatment in patients' home | Other | 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. |
| Measure | Description | Time Frame |
|---|---|---|
| readmission rates | Number of readmissions to hospital during the 6 months following discharge | 6 month post-discharge |
| Measure | Description | Time Frame |
|---|---|---|
| time to readmission | Number of days between discharge and readmission during the 6 months following discharge | 6 months |
| length of hospitalization | total number of days spent in hospital during the 6 months following discharge |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Louise Penzenstadler, MD | Contact | +41223725750 | Louise.E.Penzenstadler@hcuge.ch |
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Geneva University Hospital | Recruiting | Geneva | Switzerland |
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| ID | Term |
|---|---|
| D019966 | Substance-Related Disorders |
| ID | Term |
|---|---|
| D064419 | Chemically-Induced Disorders |
| D001523 | Mental Disorders |
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Pilot study, randomized, open, non-blinded
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| standard inpatient treatment | Other | Inpatient treatment on addiction ward |
|
| 6 months |
| number of emergency room visits | number of emergency room visits during the 6 months following discharge | 6 months |
| clinical outcome | 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. | 6 months |
| patient satisfaction | 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) | 6 months |