CPG for Psychosocial Interventions in Severe Mental ... - GuíaSalud

SR (1++)
SR (1-)
The ACT is associated with a reduction average of 40% in the use of
beds 8 .
The ACT is associated with an increase in satisfaction with the services
compared with ST (Client Satisfaction Scale: n = 120; WMD = -0.56;
95% CI: between -0.77 and -0.36) 8 .
Housing and work
The ACT reduces the probability of users becoming “homeless”, compared
with ST (n = 374; RR = 0.22, 95% CI: between 0.09 and 0.56; NNT = 10;
95% CI between 7 and 20) 8 .
Patients who receive ACT have more probabilities of living independently
than those that receive community ST (not living independently at
the end of the study: n = 362; RR = 0.70; 95% CI: between 0.57 and 0.87;
NNT = 7, 95% CI : between 5 and 17) 8 .
People who receive ACT have less probabilities of being unemployed at the end of the study
than those that receive community ST (n = 604; RR = 0.86; 95% CI: between 0.80 and 0.91; NNT
= 8; 95% CI: between 6 and 13) 8 .
Symptoms and quality of life
SR (1-)
People who receive ACT improve their mental state more than those who
receive standard community care, but the difference is small in terms of
clinical significance (BPRS/Brief Symptom Inventory/Colorado Symptom
Index: n = 255; WMD = -0.16; 95% CI: between -0.41 and -0.08) 8 .
“Homeless” people who receive ACT have probabilities of experiencing
clinically significant improvements in the quality of life, compared
with those that receive ST (General Well-being in Quality of Life Scale: n
= 125; WMD = -0.52; 95% CI: between -0.99 and -0.05) 8 .
5.3.4. Intensive Case Management (ICM)
ICM vs. Standard Case Management (CM)
ICM is associated with an increase in contact with the services, compared with that provided with
standard CM (number of losses in follow-up after 2 years: n = 1060; RR = 0.54, 95% CI: between
0.39 and 0.74) 8 .
SR (1+)
There is no significant difference between ICM and standard CM in
terms of numbers of participants who lose contact with their case manager
(n = 780; RR = 1.27; 95% CI: between 0.85 and 1.90) 8 , or in terms of readmission
rates, either (n = 747; RR = 0.95, 95% CI: between 0.85 and 1.05) 8 .
98 CLINICAL PRACTICE GUIDELINES IN THE SPANISH NHS