Prospective Study to Determine the Efficacy of Day Hospital Care to Improve Treatment Adherence for Hospitalized Schizophrenic Patients

Jin Hun Choi; So Hyun Ahn; Seong Keun Wang; Ik-Seung Chee; Jung Lan Kim; Sun Woo Lee

doi:10.4306/jknpa.2013.52.5.311

Journal List > J Korean Neuropsychiatr Assoc > v.52(5) > 1017644

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Choi, Ahn, Wang, Chee, Kim, and Lee: Prospective Study to Determine the Efficacy of Day Hospital Care to Improve Treatment Adherence for Hospitalized Schizophrenic Patients

Original Article

Journal of Korean Neuropsychiatric Association 2013; 52(5): 311-317.

Published online: 30 September 2013

DOI: https://doi.org/10.4306/jknpa.2013.52.5.311

Prospective Study to Determine the Efficacy of Day Hospital Care to Improve Treatment Adherence for Hospitalized Schizophrenic Patients

Jin Hun Choi, MD, So Hyun Ahn, MD, Seong Keun Wang, MD, PhD, Ik-Seung Chee, MD, PhD, Jung Lan Kim, MD, PhD, Sun Woo Lee, MD, PhD

Department of Psychiatry, Chungnam University School of Medicine, Daejeon, Korea.

Address for correspondence: Sun Woo Lee, MD, PhD. Department of Psychiatry, Chungnam University School of Medicine, 282 Munhwa-ro, Jung-gu, Daejeon 301-721, Korea. Tel: +82-42-280-7502, Fax: +82-42-280-7886, leesw@cnu.ac.kr

Received 18 June 2013 Revised 31 July 2013 Accepted 1 August 2013

Abstract

Objectives

The purpose of the study is to investigate the effects of day hospital care in hospitalized schizophrenic patients in terms of treatment adherence and treatment outcomes.

Methods

Among schizophrenic patients hospitalized between 2011 and 2012, 23 day hospital care patients and 40 control subjects were included in the study. All candidates underwent Beck Cognitive Insight Scale, Drug Attitude Inventory, WHO Quality of Life scale, and Psychological Well-Being Scale when their symptoms were stabilized during hospitalization, and after being discharged, 23 patients received day hospital care for two months and then changed to out-patient care while 40 patients received out-patient care immediately after discharge. At the point of two months of out-patient care, the treatment adherence of the two groups was evaluated ; tracking observation was performed until February, 2013, and survival rates were compared between the two groups.

Results

Treatment adherence was higher in the day hospital care group than in the control group. Kaplan-Meier survival analysis showed a higher survival rate for the day hospital care group compared to the control group. Levels of cognitive insight and quality of life were higher after day hospital care than before day hospital care in the day hospital care group.

Conclusion

Through the study, it was confirmed that when hospitalized schizophrenic patients receive continuous day hospital care after being discharged, they receive further out patient care more faithfully. The study is considered to aid in the understanding regarding schizophrenic patients' treatment adherence issues and improvement of treatment outcomes.

Keywords: Schizophrenia, Day hospital care, Treatment adherence, Treatment outcome

Figures and Tables

Fig. 1

Participants flow from enrollment to analysis.

Fig. 2

Kaplan-Meier survival analysis of patients with day hospital care.

Table 1

Demographic and clinical characteristics of subjects

^*: p<0.05, independent t-test. SD : Standard deviation, GAF : Global Assessment of Functioning Scale

Table 2

Comparison of treatment adherence between day hospital care group and control group

BARS : Brief Adherence Rating Scale, SD : Standard deviation

Table 3

Log Rank test of patients with day hospital care

^*: Log Rank (Mantel-Cox) test. SD : Standard deviation, CI : Confidence interval

Table 4

Comparisons of BCIS, DAI, WHOQOL, PWBS between pre-treatment and post-treatment in patients with day hospital care

^*: p<0.05, Wilcoxson signed rank test. BCIS : Beck Cognitive Insight Scale, DAI : Drug Attitude Inventory, WHOQOL : WHO Quality of Life Scale, GQOL : General QOL, PH : Physical health domain, PSYCH : Psychological domain, SR : Social relation domain, ENV : Environmental domain, PWBS : Psychological Well-Being Scale, SD : Standard deviation

Notes

The authors have no financial conflicts of interest.

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