Harrison‐Read‐UK 2000.
| Methods | Allocation: randomised. Design: single centre. Duration: 24 months. Country: London, UK. | |
| Participants | Diagnosis*: "heavy psychiatric service users", no diagnostic criteria reported. N = 193. Setting: community psychiatric services. Age: 16 to 64 years, mean ˜ 39 years. Sex: 53% M (102M, 91F). History: admitted within the last 3 years and had at least 2 admissions in the last 6.5 years. Excluded: participants who were continuously hospitalised during 8 months' recruitment. | |
| Interventions | 1. ICM: enhanced community management on ACT principles (Stein model) provided by dedicated multiprofessional team. Caseload: 1:8‐15. N = 97. 2. Non‐ICM: locality‐based community psychiatric services using the UK Care Programme Approach. Caseload: 1 ≧20. N = 96. | |
| Outcomes | Service use: average number of days in hospital per month.
Death: all causes, suicide.
Global state: leaving the study early, compliance, Rating of Medication Influences (ROMI).
Social functioning: Social Functioning Questionnaire (SFQ).
Mental state: Krawiecka Scale (KS), Health of the Nation Outcome Scale (HoNOS), Hospital Anxiety and Depression Scale (HADS).
Participant satisfaction: Camberwell Assessment of Need (CAN).
Costs: direct costs of psychiatric hospital care. Unable to use ‐ Mental state: general symptoms, Well‐being Questionnaire (W‐BQ) (not peer‐reviewed scale and modified from the original). |
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| Notes | *Schizophrenia ˜ 65%. **Median number of 5 admissions over 6.5 years. | |
| Risk of bias | ||
| Bias | Authors' judgement | Support for judgement |
| Random sequence generation (selection bias) | Low risk | Random sequence generated by computer program. |
| Allocation concealment (selection bias) | Unclear risk | No details |
| Blinding (performance bias and detection bias) All outcomes | Unclear risk | Primary outcome: clinician/participant mediated ‐ rating ‐ Unclear. Secondary outcomes: some are interviewer rated ‐ rating ‐ No. Interviewers are not blind to treatment assignment. |
| Blinding of participants and personnel (performance bias) All outcomes | Unclear risk | Blinding not reported. |
| Blinding of outcome assessment (detection bias) All outcomes | High risk | Interviewers were not blinded. |
| Incomplete outcome data (attrition bias) All outcomes | Unclear risk | Number of lost to follow‐up reported, but reasons for attrition not reported. Number of lost to follow‐up balanced between 2 groups. Some participants were excluded after randomisation, but reasons for exclusion not stated. |
| Selective reporting (reporting bias) | Low risk | Listed outcomes of interest are fully reported. |
| Other bias | Low risk | Publicly funded (National Health Service). No further details. No evidence of other bias. |