Abstract

AimsTo examine the impact of using Communty Treatment Orders (CTO) of the Mental Health Act on use of inpatient care in Assertive Outreach team.BackgroundCurrently there is little evidence of the efficacy of community treatment orders (CTOs), and in particular with patients who use the Assertive Outreach service. One large randomised controlled study found no impact on use of inpatient care while a naturalistc study found significant impact.MethodOur primary outcome was the number of admissions with and without a CTO comparing each patient with themselves before CTO and under CTO(“mirror-image”). Our secondary outcomes were the number of bed days, and the percentage of missed community visits post-discharge. We also looked at the potential cost savings of a reduction in inpatient bed usage.ResultAll the 63 patients studied over period of 6 years had a severe and enduring mental illness. The use of a CTO was linked to a significant reduction in the number of admissions (mean difference = 0.89, 95% CI = 0.53–1.25, P < 0.0001) and bed days (mean difference = 158.65, 95% CI = 102.21–215.09, P < 0.0001) There was no significant difference in the percentage of missed community visits post-discharge. Looking at the costs, an average cost for an inpatient Assertive Outreach bed per day in the local Trust was £250, and there were 8145 bed days saved in total, making a potential saving of just over £2million, during the study period.ConclusionThis study suggests that the implementation of CTOs using clinical judgment and knowledge of patients can significantly reduce the bed usage of Assertive Outreach patients. The financial implications of CTOs need to be reviewed further, but this study does suggest that the implementation of CTOs is a cost-effective intervention and is economically advantageous to the local Trust.

Highlights

  • Midwakh, which involves smoking an Arabian tobacco blend typically mixed with herbs and spices, has recently become a major health concern due to a spreading popularity among adolescents and young adults in the United Arab Emirates (UAE)

  • Percentages and means were calculated for demographic data and Chi-Square was utilised to measure relations between categorical variables

  • Odds Ratio (OR) was used to estimate how strongly a predictor was associated to an outcome

Read more

Summary

Introduction

Midwakh, which involves smoking an Arabian tobacco blend typically mixed with herbs and spices, has recently become a major health concern due to a spreading popularity among adolescents and young adults in the United Arab Emirates (UAE). It is known to contain a higher nicotine content than cigarettes, potentially increasing the risk of addiction, despite contrary popular belief among young smokers. Little is known about attitudes and decision-making processes involving this emerging smoking behaviour. The aim of this study was to ascertain the knowledge, attitudes and practices of Midwakh use among adult males in the UAE.

Results
Conclusion
Full Text
Published version (Free)

Talk to us

Join us for a 30 min session where you can share your feedback and ask us any queries you have

Schedule a call