Is it time for a more nuanced view on self‐admission to in‐patient treatment in psychiatry?

Strand, Mattias; Hausswolff-Juhlin, Yvonne von

doi:10.1111/acps.12903

Cited by 1 publication

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References 5 publications

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“…Pilot studies on Norwegian self‐admission programs targeting patients with schizophrenia and bipolar disorder have been promising: time spent in inpatient treatment was reduced by 22–56% and time spent in involuntary inpatient treatment by 51–61% across studies (Hanneborg & Ruud, 2011; Heskestad & Tytlandsvik, 2008; Sollied & Måsø Helland, 2010; Støvind, Hanneborg, & Ruud, 2012; Tytlandsvik & Heskestad, 2009). More recent controlled studies in the same patient groups from Norway (Sigrunarson, Moljord, Steinsbekk, Eriksen, & Morken, 2016) and Denmark (Thomsen et al, 2018) have, however, presented a somewhat sobering picture with control groups subjected to treatment as usual reducing their utilization of inpatient treatment in equal proportions to or even more than self‐admission participants (Strand & von Hausswolff‐Juhlin, 2018). The self‐admission program at the Stockholm Centre for Eating Disorders (SCÄ) described in the present article is the first to target patients with an eating disorder.…”

Section: Introductionmentioning

confidence: 99%

Self‐admission to inpatient treatment in anorexia nervosa: Impact on healthcare utilization, eating disorder morbidity, and quality of life

Strand

Bulik

Gustafsson

et al. 2020

Intl J Eating Disorders

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Objective: Little evidence exists concerning the optimal model of inpatient care for patients with longstanding anorexia nervosa (AN). Self-admission has been developed as a treatment tool whereby patients with a history of high healthcare utilization are invited to decide for themselves when brief admission is warranted. The aim of this study was to evaluate the impact of a self-admission program on healthcare utilization, eating disorder morbidity, health-related quality of life (HRQoL), and sick leave for patients with AN. Method: In this cohort study, 29 participants with AN in a Swedish self-admission program were compared to 113 patients with longstanding illness but low previous utilization of inpatient treatment, matched based on age, illness duration, and bodymass index (BMI). Data on healthcare utilization, eating disorder morbidity, and sick leave were obtained from national population and eating disorder quality registers. Results: Participants displayed a >50% reduction in time spent hospitalized at 12month follow-up, compared to nonsignificant changes in the comparison group. A sensitivity analysis comparing participants to a moderate-utilization comparison subgroup strengthened this observation. In contrast, the approach did not affect participants' BMI or eating disorder morbidity. Regarding HRQoL, mixed results were observed. In terms of sick leave, a beneficial but nonsignificant pattern was seen for participants. Discussion: These findings indicate that self-admission is a viable and helpful tool within a recovery model framework, even though it does not lead to symptom remission. In its proper context, self-admission could potentially transform healthcare from crisis-driven to pre-emptive, and promote autonomy for severely ill patients.

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Section: Introductionmentioning

confidence: 99%