Reducing emergency medical service use in patients with chronic psychotic disorders: results from the FAST intervention study
- PMID: 17997395
- PMCID: PMC2249612
- DOI: 10.1016/j.brat.2007.10.001
Reducing emergency medical service use in patients with chronic psychotic disorders: results from the FAST intervention study
Abstract
Patients with schizophrenia have disproportionately high rates of emergency medical service use, likely contributing to the high cost this illness places on society. The aim of this study was to examine the impact of a theory-based, behavioral intervention on immediate and long-term use of emergency medical services. Older patients with schizophrenia (n=240) were randomized to receive either a behavioral, skills-building intervention known as Functional Adaptation and Skills Training (FAST) or a time-equivalent attention-control condition (AC). Logistic regression analyses indicated that AC participants were nearly twice as likely to use emergency medical services in general (OR=2.54; p=0.02) and emergency psychiatric services in particular (OR=3.69; p=0.05) during the active intervention phase of the study. However, there were no differences between the interventions in terms of emergency service use during the long-term follow-up phase of the study (i.e., 6-18 months post-baseline). The FAST intervention appears efficacious for reducing the short-term risk of using emergency medical services. However, the long-term efficacy of the FAST intervention appears less clear. Future studies may want to provide more powerful maintenance sessions to encourage continued use of skills in patients' real-world settings.
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References
-
- American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. 4. Washington, DC: American Psychiatric Association; 2000. Text Revision, Trans.
-
- Carr VJ, Johnston PJ, Lewin TJ, Rajkumar S, Carter GL, Issakidis C. Patterns of service use among persons with schizophrenia and other psychotic disorders. Psychiatric Services. 2003;54(2):226–235. - PubMed
-
- Cheeseman JC. Population projections of the United States by age, sex, race, and Hispanic origin: 1995 to 2050. Washington, DC: U.S. Government Printing Office; 1996.
-
- Clarke GN, Herincks HA, Kinney RF, Paulson RI, Cutler DL, Lewis K, et al. Psychiatric hospitalizations, arrests, emergency room visits, and homelessness of clients with serious and persistent mental illness: Findings from a randomized trial of two ACT programs vs. usual care. Mental Health Services Research. 2000;2(3):155–164. - PubMed
-
- Ellison JM, Blum N, Barsky AJ. Repeat visitors in the psychiatric emergency service: A critical review of the data. Hospital & Community Psychiatry. 1986;37(1):37–41. - PubMed
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