Effective Healthcare
Bulletin on the effectiveness of health service interventions for decision makers
Source: Centre for Reviews and Dissemination, University of York
- Comprehensive care for schizophrenia involves not only drug treatments, but also the provision of ongoing support, valid information and, where appropriate, therapies or rehabilitative strategies.
- Individual psychoeducational interventions can decrease the risk of relapse, although the mechanism by which this is achieved is unclear.
- Family intervention (a supportive, educational and, perhaps, therapeutic interaction with the family of people with schizophrenia) decreases the risk of relapse. However, this decrease was most marked with early studies undertaken by pioneers of the technique.
- Evidence suggests that cognitive behavioural therapy may decrease relapse and readmission rates and may also improve the patient's mental state.
- Assertive community treatment (ACT) reduces hospital admissions and time spent in hospital by nearly 50%. ACT teams could prove particularly useful in environments where psychiatric in-patient care is at a premium.
- The Care Programme Approach (case management) may help health and social services keep contact with people, and may serve useful administrative functions, but ACT is required to keep severely mentally ill people out of hospital.
- The whole area of non-pharmacological treatments for people with schizophrenia is under researched. Well-designed, generalisable randomised controlled trials are needed. These should involve people seen in everyday practice, and measure meaningful outcomes, including adverse effects.
The Effective Health Care bulletins are based on systematic review and synthesis of research on clinical effectiveness, cost effectiveness and acceptability of health service interventions. This is carried out by a research team using established methodological guidelines, with advice from expert consultants for each topic. Great care is taken to ensure that the work, and the conclusions reached, fairly and accurately summarise the research findings. The University of York accepts no responsibility for any consequent damage arising from the use of Effective Health Care.
Note: The contents of the bulletins should be considered in relation to the time of original publication. Significant new research evidence is likely to have become available since then.
The bulletins are also available free of charge via the World Wide Web. The address is: www.york.ac.uk/inst/crd/ehcb.htm
Enquiries concerning the bulletins should be addressed to:
Centre for Reviews and Dissemination, University of York, York, YO10 5DD. Telephone: +44 (0) 1904 321040; Fax: +44 (0) 1904 321041; email: crd@york.ac.uk
Psychosocial Interventions for Schizophrenia. Effective Health Care, August 2000, Volume 6, Number 3. ISSN: 0965-0288
