Assertive community treatment in the Netherlands: a randomized controlled trial
Article first published online: 9 MAY 2007
Acta Psychiatrica Scandinavica
Volume 116, Issue 2, pages 105–112, August 2007
How to Cite
Sytema, S., Wunderink, L., Bloemers, W., Roorda, L. and Wiersma, D. (2007), Assertive community treatment in the Netherlands: a randomized controlled trial. Acta Psychiatrica Scandinavica, 116: 105–112. doi: 10.1111/j.1600-0447.2007.01021.x
- Issue published online: 9 MAY 2007
- Article first published online: 9 MAY 2007
- Accepted for publication March 14, 2007
- community mental health services;
- case management;
- randomized clinical trials;
- long-term outcome
Objective: Assertive community treatment is rapidly implemented by many European mental health services, but recently the evidence base has been questioned. Positive results of randomized trials in the USA were not replicated in the UK. The question is whether the UK findings are representative for other European countries with modern mental health services.
Method: Open randomized controlled trial of long-term severely mentally ill patients [Health of the Nation Outcome Scales (HoNOS) total score ≥15], assigned to assertive community treatment (n = 59) or to standard community mental health care (n = 59). Primary outcome: sustained contact; housing stability and admission days. This trial is registered as an International Standard Randomized Clinical Trial, number ISRCTN 11281756.
Results: Assertive community treatment was significantly better in sustaining contact with patients, but not in reducing admission days. No differences in housing stability, psychopathology, social functioning or quality of life were found.
Conclusion: The results are in agreement with UK studies. However, the sustained contact potential of assertive community treatment is important, as too many patients are lost in standard care.