Patient-controlled hospital admission for patients with severe mental disorders: a nationwide prospective multicentre study. Thomsen, C. T., Benros, M. E., Maltesen, T., Hastrup, L. H., Andersen, P. K., Giacco, D., & Nordentoft, M. Acta Psychiatrica Scandinavica, 137(4):355–363, April, 2018. Number: 4doi abstract bibtex OBJECTIVE: To assess whether implementing patient-controlled admission (PCA) can reduce coercion and improve other clinical outcomes for psychiatric in-patients. METHODS: During 2013-2016, 422 patients in the PCA group were propensity score matched 1:5 with a control group (n = 2110) that received treatment as usual (TAU). Patients were followed up for at least one year using the intention to treat principle utilising nationwide registers. In a paired design, the outcomes of PCA patients during the year after signing a contract were compared with the year before. RESULTS: No reduction in coercion (risk difference = 0.001; 95% CI: -0.038; 0.040) or self-harming behaviour (risk difference = 0.005; 95% CI: -0.008; 0.018) was observed in the PCA group compared with the TAU group. The PCA group had more in-patient bed days (mean difference = 28.4; 95% CI: 21.3; 35.5) and more medication use (P \textless 0.0001) than the TAU group. Before and after analyses showed reduction in coercion (P = 0.0001) and in-patient bed days (P = 0.0003). CONCLUSION: Implementing PCA did not reduce coercion, service use or self-harm behaviour when compared with TAU. Beneficial effects of PCA were observed only in the before and after PCA comparisons. Further research should investigate whether PCA affects other outcomes to better establish its clinical value.
@article{thomsen_patient-controlled_2018,
title = {Patient-controlled hospital admission for patients with severe mental disorders: a nationwide prospective multicentre study},
volume = {137},
issn = {1600-0447},
shorttitle = {Patient-controlled hospital admission for patients with severe mental disorders},
doi = {10.1111/acps.12868},
abstract = {OBJECTIVE: To assess whether implementing patient-controlled admission (PCA) can reduce coercion and improve other clinical outcomes for psychiatric in-patients.
METHODS: During 2013-2016, 422 patients in the PCA group were propensity score matched 1:5 with a control group (n = 2110) that received treatment as usual (TAU). Patients were followed up for at least one year using the intention to treat principle utilising nationwide registers. In a paired design, the outcomes of PCA patients during the year after signing a contract were compared with the year before.
RESULTS: No reduction in coercion (risk difference = 0.001; 95\% CI: -0.038; 0.040) or self-harming behaviour (risk difference = 0.005; 95\% CI: -0.008; 0.018) was observed in the PCA group compared with the TAU group. The PCA group had more in-patient bed days (mean difference = 28.4; 95\% CI: 21.3; 35.5) and more medication use (P {\textless} 0.0001) than the TAU group. Before and after analyses showed reduction in coercion (P = 0.0001) and in-patient bed days (P = 0.0003).
CONCLUSION: Implementing PCA did not reduce coercion, service use or self-harm behaviour when compared with TAU. Beneficial effects of PCA were observed only in the before and after PCA comparisons. Further research should investigate whether PCA affects other outcomes to better establish its clinical value.},
language = {eng},
number = {4},
journal = {Acta Psychiatrica Scandinavica},
author = {Thomsen, C. T. and Benros, M. E. and Maltesen, T. and Hastrup, L. H. and Andersen, P. K. and Giacco, D. and Nordentoft, M.},
month = apr,
year = {2018},
pmid = {29504127},
note = {Number: 4},
keywords = {Adult, Case-Control Studies, Coercion, Denmark, Female, Follow-Up Studies, Humans, Male, Mental Disorders, Middle Aged, Patient Acceptance of Health Care, Patient Admission, Registries, Self-Injurious Behavior, coercion, epidemiology, mental disorders, mental health services, patient participation},
pages = {355--363},
}
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METHODS: During 2013-2016, 422 patients in the PCA group were propensity score matched 1:5 with a control group (n = 2110) that received treatment as usual (TAU). Patients were followed up for at least one year using the intention to treat principle utilising nationwide registers. In a paired design, the outcomes of PCA patients during the year after signing a contract were compared with the year before. RESULTS: No reduction in coercion (risk difference = 0.001; 95% CI: -0.038; 0.040) or self-harming behaviour (risk difference = 0.005; 95% CI: -0.008; 0.018) was observed in the PCA group compared with the TAU group. The PCA group had more in-patient bed days (mean difference = 28.4; 95% CI: 21.3; 35.5) and more medication use (P \\textless 0.0001) than the TAU group. Before and after analyses showed reduction in coercion (P = 0.0001) and in-patient bed days (P = 0.0003). CONCLUSION: Implementing PCA did not reduce coercion, service use or self-harm behaviour when compared with TAU. Beneficial effects of PCA were observed only in the before and after PCA comparisons. Further research should investigate whether PCA affects other outcomes to better establish its clinical value.","language":"eng","number":"4","journal":"Acta Psychiatrica Scandinavica","author":[{"propositions":[],"lastnames":["Thomsen"],"firstnames":["C.","T."],"suffixes":[]},{"propositions":[],"lastnames":["Benros"],"firstnames":["M.","E."],"suffixes":[]},{"propositions":[],"lastnames":["Maltesen"],"firstnames":["T."],"suffixes":[]},{"propositions":[],"lastnames":["Hastrup"],"firstnames":["L.","H."],"suffixes":[]},{"propositions":[],"lastnames":["Andersen"],"firstnames":["P.","K."],"suffixes":[]},{"propositions":[],"lastnames":["Giacco"],"firstnames":["D."],"suffixes":[]},{"propositions":[],"lastnames":["Nordentoft"],"firstnames":["M."],"suffixes":[]}],"month":"April","year":"2018","pmid":"29504127","note":"Number: 4","keywords":"Adult, Case-Control Studies, Coercion, Denmark, Female, Follow-Up Studies, Humans, Male, Mental Disorders, Middle Aged, Patient Acceptance of Health Care, Patient Admission, Registries, Self-Injurious Behavior, coercion, epidemiology, mental disorders, mental health services, patient participation","pages":"355–363","bibtex":"@article{thomsen_patient-controlled_2018,\n\ttitle = {Patient-controlled hospital admission for patients with severe mental disorders: a nationwide prospective multicentre study},\n\tvolume = {137},\n\tissn = {1600-0447},\n\tshorttitle = {Patient-controlled hospital admission for patients with severe mental disorders},\n\tdoi = {10.1111/acps.12868},\n\tabstract = {OBJECTIVE: To assess whether implementing patient-controlled admission (PCA) can reduce coercion and improve other clinical outcomes for psychiatric in-patients.\nMETHODS: During 2013-2016, 422 patients in the PCA group were propensity score matched 1:5 with a control group (n = 2110) that received treatment as usual (TAU). Patients were followed up for at least one year using the intention to treat principle utilising nationwide registers. In a paired design, the outcomes of PCA patients during the year after signing a contract were compared with the year before.\nRESULTS: No reduction in coercion (risk difference = 0.001; 95\\% CI: -0.038; 0.040) or self-harming behaviour (risk difference = 0.005; 95\\% CI: -0.008; 0.018) was observed in the PCA group compared with the TAU group. The PCA group had more in-patient bed days (mean difference = 28.4; 95\\% CI: 21.3; 35.5) and more medication use (P {\\textless} 0.0001) than the TAU group. Before and after analyses showed reduction in coercion (P = 0.0001) and in-patient bed days (P = 0.0003).\nCONCLUSION: Implementing PCA did not reduce coercion, service use or self-harm behaviour when compared with TAU. Beneficial effects of PCA were observed only in the before and after PCA comparisons. Further research should investigate whether PCA affects other outcomes to better establish its clinical value.},\n\tlanguage = {eng},\n\tnumber = {4},\n\tjournal = {Acta Psychiatrica Scandinavica},\n\tauthor = {Thomsen, C. T. and Benros, M. E. and Maltesen, T. and Hastrup, L. H. and Andersen, P. K. and Giacco, D. and Nordentoft, M.},\n\tmonth = apr,\n\tyear = {2018},\n\tpmid = {29504127},\n\tnote = {Number: 4},\n\tkeywords = {Adult, Case-Control Studies, Coercion, Denmark, Female, Follow-Up Studies, Humans, Male, Mental Disorders, Middle Aged, Patient Acceptance of Health Care, Patient Admission, Registries, Self-Injurious Behavior, coercion, epidemiology, mental disorders, mental health services, patient participation},\n\tpages = {355--363},\n}\n\n\n\n","author_short":["Thomsen, C. T.","Benros, M. E.","Maltesen, T.","Hastrup, L. H.","Andersen, P. 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