Home-Treatment in Child and Adolescent Psychiatry: An Analysis of the Effectiveness and Possible Implementation in Austria

Wolf S, Grössmann N
Record ID 32018000872
Original Title: Home-Treatment in der Kinder- und Jugendpsychiatrie: Eine Analyse zur Wirksamkeit und möglichen Implementierung in Österreich
Authors' objectives: The Austrian child and adolescent psychiatric care landscape is characterised by substantial deficits on the intramural as well as on the extramural level. To overcome these supply shortfalls, alternative outreach approaches, such as home-treatment (HT), can be introduced to facilitate the reduction of hospitalisations. The present report aimed to systematically characterise international HT-models considering their effectiveness and safety in the area of child and adolescent psychiatry.
Authors' results and conclusions: The evidence on effectiveness included four endpoints: change in symptoms, hospitalisation, treatment satisfaction and need for further treatment. A benefit of HT-models compared to stationary care could be identified considering psychosocial symptoms; however, solely in the long-term follow-up. Studies have also shown that HT is associated with fewer days of hospitalisation, but with a high proportion of patients needing further treatment after HT. Inconclusive evidence was identified considering treatment satisfaction. Safety endpoints were not evaluated by any of the included studies.
Authors' recomendations: Before implementing an HT-programme, the professional groups, the types of therapies and the target patient population should be defined. Moreover, functions and responsibilities for the coordination between HT-teams and other healthcare providers, as well as a financing strategy and a legal basis should be elaborated, preferably on the federal state level. Therefore, existing capacities of the intramural and extramural child and adolescent psychiatric sector, including personnel and coordinating resources, should be sufficiently established. In any case, an accompanying evaluation of an HT-programme is recommended to promote future evidence-based developments in the field of child and adolescent psychiatry.
Authors' methods: A systematic literature search in six databases, as well as an extended hand search was conducted. Taking into account the predefined inclusion and exclusion criteria, eleven publications on six HT-studies were eligible for the qualitative synthesis; comprising two randomised controlled trials (RCTs), two non-randomised controlled trials (NRCTs) and two observational studies. In addition, semistructured consultations with Austrian multidisciplinary experts were conducted.
Project Status: Completed
Year Published: 2020
URL for additional information: http://eprints.aihta.at/1275/
English language abstract: An English language summary is available
Publication Type: Full HTA
Country: Austria
MeSH Terms
  • Child Psychiatry
  • Adolescent Psychiatry
  • Home Care Services
  • Austria
  • Home treatment
  • child and adolescent psychiatry
  • effectiveness and safety
  • implementation criteria
Organisation Name: Austrian Institute for Health Technology Assessment
Contact Address: Garnisongasse 7/20, A-1090 Vienna, Austria
Contact Name: office@aihta.at
Contact Email: office@aihta.at
Copyright: AIHTA
This is a bibliographic record of a published health technology assessment from a member of INAHTA or other HTA producer. No evaluation of the quality of this assessment has been made for the HTA database.