Early Intervention in Psychosis: Health of the Nation Outcome Scales (HoNOS) Outcomes From a Five-Year Prospective Study

Penno, Steve; Hamilton, Bridget; Petrakis, Melissa

doi:10.1016/j.apnu.2017.07.003

Cited by 11 publications

(11 citation statements)

References 45 publications

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“…These findings go hand in hand with results in previous studies in other countries [51][52][53][54]. Nevertheless, the reasons for the higher chance of developing poor health status are not clear, but, generally, differences in prevalence are related to study factors, periods of measurement, operational definitions, and measurement use, as well as the targeted populations.…”

Section: Table 2 Mental Hospital Characteristicssupporting

confidence: 48%

Hospital and patient factors influencing the health status among patients with schizophrenia, thirty days after hospital discharge: multi-level analysis

et al. 2020

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Background The time between discharge from hospital and transition to community and home is a critical period for health status among patients with a mental illness, including patients with schizophrenia. This study aimed to investigate crucial patient factors (patient-level) and hospital factors (hospital-level) affecting health status and see whether patient factor effects on health status vary with hospital factors, 30 days after hospital discharge. Methods This is a prospective study of 1255 patients with schizophrenia and their primary caregivers from 13 public mental hospitals across Thailand. Logistic regression and multi-level logistic regression was used to investigate the effects of patient and hospital factors simultaneously on health status, 30 days after hospital discharge. Results The intraclass correlation coefficient indicated that 14% of the change in health status was explained by the differences between hospital. Poor health status was identified in 14.26% of patients, 30 days after hospital discharge. The majority of participant patients were male (69.8%), single (71.87%), and the average age was 38.09 (SD = 9.74). The finding also showed that the patient factors; being female (ORadj .53, 95%CI .31,.92), perceived moderate and high levels of positive aspect of caregiving (ORadj .24, 95%CI .14,.42 and ORadj .05, 95%CI .02,.09), perceived readiness for hospital discharge (ORadj .21, 95%CI .13,.33), partial and full adherence to treatment (ORadj .24, 95%CI .14,.42 and ORadj .31, 95%CI .20,.47) showed a reduced likelihood of developing poor health status except substance use (ORadj 1.55, 95%CI .98, 2.44). Hospital factors; discharge planning process and nurse-patient ratio (ORadj 1.64, 95%CI 1.17, 2.30 and ORadj 1.16, 95%CI 1.09, 1.22) showed an increased likelihood of developing poor health status, 30 days after hospital discharge. Conclusions Findings provide relevant information on how both patient and hospital factors determine health status. These results might lead to better targeting of mental health service policy and enable more precise information gathering and allocation of resources. However, future research should be more focused and continue investigating the pathways through which hospital factors influence health status post-discharge.

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Section: Table 2 Mental Hospital Characteristicssupporting

confidence: 48%

Hospital and patient factors influencing the health status among patients with schizophrenia, thirty days after hospital discharge: multi-level analysis

et al. 2020

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“…Items are grouped in four subscales: behavioural problems, impairment problems, symptoms problems and social problems (Preti et al, 2012). The HoNOS proved reliable against other ratings of outcome assessment in first‐episode psychosis (Penno, Hamilton, & Petrakis, 2017; Preti et al, 2012; Turner, Boden, Smith‐Hamel, & Mulder, 2009) as well as other disorders (Eagar, Trauer, & Mellsop, 2005; Trauer, 2010). Assessments were conducted at baseline and every 6 months up to 24 months or longer.…”

Section: Methodsmentioning

confidence: 86%

First‐episode psychosis in the Ferrara Mental Health Department: Incidence and clinical course within the first 2 years

Murri

Bertelli²,

Carozza³

et al. 2020

Early Intervention Psych

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Aim To examine the incidence of with first‐episode psychosis (FEP) in the Integrated Department of Mental Health and Pathological Addictions in Ferrara, Italy, and to examine the association between the Duration of Untreated Psychosis (DUP) and the clinical course. Methods Participants recruited in 2013–2019 were assessed with the Health of the Nation Outcome Scale (HoNOS) every 6 months for 24 months. Hierarchical growth models analysed changes of global severity (HoNOS total scores) and symptom dimensions. Regression modelled factors associated with remission (HoNOS < 8) and clinical improvement (<12). Results The incidence of FEP was 21.5 (95%CI: 21.2–21.9) cases per 100 000 person year. Among participants (n = 86, mean age 23, 76% males), baseline HoNOS scores were higher for those with a longer DUP. More than half subjects reached clinical remission (61.6%) or improvement (82.6%), while very few (2.3%) were re‐hospitalized. HoNOS total scores decayed with a mixed linear/quadratic trend, with a slower decay among migrants. A longer DUP was associated with reduced improvements of positive symptoms and lower likelihood of clinical improvement (OR: 0.84; 95%CI: 0.73–0.96). Conclusions Patients from the FEP program of Ferrara reached good clinical outcomes. Nonetheless, individuals with a longer DUP may need additional clinical attention. Systematic monitoring of clinical outcomes may be an optimal strategy to improve the outcomes of FEP in the real world.

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“…Evaluating the HoNOS data-set in the UK provides a unique insight into the effectiveness of modern mental healthcare, at scale. Previous work in Italy and Australia has been encouraging in looking at outcomes from generic mental health treatment, 7,8 while in the UK, studies have examined predictors of outcome and variability between providers 9 as well as outcomes for individual services, [10][11][12][13][14] on the whole showing a picture of improved outcomes. In reality, patients often move between several services during the course of their treatment and thus what remains of interest, not least to patients, is whether outcomes improve from the experience as a whole.…”

Section: Outcome Measures and Payment In Mental Healthmentioning

confidence: 99%

Effectiveness of treatment for 6813 patients with mental health conditions in Cambridgeshire: a cross-sectional study

2020

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Background The Health of the Nation Outcomes Scales (HoNOS) has been widely used as an outcome measure in UK mental health settings for the past decade. The data-set gathered provides a unique opportunity to evaluate the effectiveness of the totality of mental healthcare in ‘real-world’ conditions; much of our clinical evidence currently comes from highly parameterised clinical trials investigating single interventions in highly selected patients. Aims To examine all outcomes measured by HoNOS for a range of diagnostic groups, evaluate the influence of patient demographics on those outcomes, and observe changes in patient groups over time. Method Here we show the data from 6813 adult patients treated in Cambridgeshire between 2012 and 2017. Patients were split into three diagnostic groups: psychosis, non-psychosis and organic. Changes in HoNOS scores from initial assessment to discharge were tested and regressions were used to evaluate the influence of age, gender and ethnicity on the changes, as well as to model changes in the severity of initial presenting symptoms with time. Results HoNOS scores significantly improve after treatment for psychotic, non-psychotic and organic conditions in adults and older adults. Age, but not gender or ethnicity, influenced change in HoNOS scores. Patients entering secondary mental health services had increased initial HoNOS scores over time. Conclusions The UK repository of HoNOS scores provides a significant and relatively underutilised resource that can be exploited to gain insights into mental illness and treatment effectiveness. This is likely to have many applications, including influencing the commissioning of services.

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Early Intervention in Psychosis: Health of the Nation Outcome Scales (HoNOS) Outcomes From a Five-Year Prospective Study

Cited by 11 publications

References 45 publications

Hospital and patient factors influencing the health status among patients with schizophrenia, thirty days after hospital discharge: multi-level analysis

Hospital and patient factors influencing the health status among patients with schizophrenia, thirty days after hospital discharge: multi-level analysis

First‐episode psychosis in the Ferrara Mental Health Department: Incidence and clinical course within the first 2 years

Effectiveness of treatment for 6813 patients with mental health conditions in Cambridgeshire: a cross-sectional study

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