Implementation Efficacy and Costs of Inpatient Equivalent Home-Treatment in German Mental Health Care

  • STATUS
    Recruiting
  • End date
    Jun 30, 2023
  • participants needed
    820
  • sponsor
    Vivantes Netzwerk für Gesundheit GmbH
Updated on 16 February 2021

Summary

The "inpatient-equivalent home treatment"(IEHT) according to 115d SGB-V is a particular version of the internationally well-known and evidence-based Home Treatment. As a complex intervention, IEHT requires a multi-method evaluation on different levels in the German context. The AKtiV study that is financed by the Innovation Fund of the Federal Joint Committee (proposal ID: VSF2_2019-108) meets this request. In this quasi-experimental study with a propensity score-matched control group, we assess and combine quantitative and qualitative data. Outcome parameters include classical clinical ones such as hospital readmission rates, mental state, and recovery outcomes. In addition, it evaluates issues concerning the right target population, treatment processes, implementation strategies, and factors associated with positive outcomes. The study takes into account the perspective of patients, relatives, staff as well as decision makers in politics and administration. Therefore, we expect the results to be relevant for a broad audience and to contribute to further refinement and adaption of the model.

Description

The overarching goal of the AKtiV trial is to examine implementation processes, treatment processes, clinical efficacy, costs, and subjective experiences of IEHT following 115d of the German Social Code Book Five (SGB-V)compared to inpatient treatment from the perspective of service users, relatives or rather informal care givers' , staff and other stakeholders in mental health care. To maximize transferability of study results and to cover a broad spectrum of IEHT experience, 10 hospitals from different regions of Germany (e.g. rural, urban, east, west) participate in this study. Combining routine data, primary data and prospective follow-up data, the study results will be based/ involve a comprehensive database. Further, the combination of clinical and health economic data will enable the assessment of costs and benefits from a national perspective, a particularity of importance, given that there are only a few studies with health economic evidence of acute outreach mental health care. The qualitative evaluation of processes and out-comes of IEHT uses a collaborative-participatory approach that aligns with current demands for more user orientation and/ or involvement of people and researchers with lived experience in the process of developing interventions and their evaluation. The mixed-methods design of the trial corresponds with current standards of empirical social research enabling the triangulation of hypothesis-confirming, quantifiable factors and hypothesis-generating, qualitative aspects. By parallelizing on one hand quantitative and qualitative data and on the other hand routine data with primary data, data on implementation processes and data on treatment processes, different facets from different perspectives and levels of IEHT are targeted. This allows for a comprehensive, holistic assessment of this innovative treatment offer.

Details
Condition Psychosis, Psychosis, Addiction, Addictions, Mental illness, PERSONALITY DISORDER, Eating Disorders, ANXIETY NEUROSIS, Anxiety Disorders, Generalized Anxiety Disorder (GAD), Anxiety Disorders (Pediatric), Generalized Anxiety Disorder (GAD - Pediatric), Anxiety Disorders (Pediatric), Generalized Anxiety Disorder (GAD), Psychological Disorders, Generalized Anxiety Disorder (GAD - Pediatric), Anxiety Disorders, Addictions, eating disorder, psychiatric disorder, psychiatric illness, mental disorder, psychiatric disorders, mental disorders, psychological disorder, psychiatric diseases, psychiatric disease, mental disease, addictive behaviors, schizoaffective disorder, disorders, eating, anxiety disorder, psychotic disorders, psychotic, psychotic disorder
Treatment Inpatient Equivalent Home Treatment
Clinical Study IdentifierNCT04745507
SponsorVivantes Netzwerk für Gesundheit GmbH
Last Modified on16 February 2021

Eligibility

Yes No Not Sure

Inclusion Criteria

informed consent regarding study participation
For C4: IEHT staff member of participating study cite OR local or political
stakeholder engaged with IEHT
Inclusion criteria
informed consent regarding study participation

Exclusion Criteria

IEHT exclusion criteria
in case of children living in the same household, presence of child welfare risk
acute suicidality or aggressiveness towards others requiring hospital admission
Being under order of commitment
participation in an interventional study during the recruitment
presence of substantial cognitive deficits as indicated by severe organic brain disease
diagnosis of intellectual impairment
admission longer ago than 7 days
For C3: Close relative or informal caregiver living in the same household of
the participating patient
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