SynthesisSocial psychiatry and psychiatric epidemiology2014
CTOs: what is the state of the evidence?
Synthesis in Social psychiatry and psychiatric epidemiology, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
20 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Compulsory community and involuntary outpatient treatment for people with severe mental disorders.The Cochrane database of systematic reviews · 2017Pooled it
- Community treatment orders and social outcomes for patients with psychosis: a 48-month follow-up study.Social psychiatry and psychiatric epidemiology · 2017Trial
- The association between Compulsory Community Treatment Order status and mortality in New Zealand.BJPsych open · 2023Article
- Article
- Protecting Health and Safety with Needed-Treatment: the Effectiveness of Outpatient Commitment.The Psychiatric quarterly · 2022Review
- Compulsory Community Treatment Orders in New Zealand and the provision of care: An examination of national databases and predictors of outcome.The Lancet regional health. Western Pacific · 2021Article
- Hospital Utilization Outcomes Following Assignment to Outpatient Commitment.Administration and policy in mental health · 2021Review
- Finding Common Ground for Diverging Policies for Persons with Severe Mental Illness.The Psychiatric quarterly · 2020Review
- Community Treatment Order Outcomes in Quebec: A Unique Jurisdiction.Canadian journal of psychiatry. Revue canadienne de psychiatrie · 2020Article
- Different Patient Group Responses To Community Treatment Orders Suggest Alternative Approaches.Professional development (Philadelphia, Pa.) · 2020Article
- Is it the right time to implement Community Treatment Order in India?Indian journal of psychiatry · 2019Review
- Patients on outpatient commitment orders in Northern Norway.BMC psychiatry · 2017Article
- Little evidence for community treatment orders - a battle fought with heavy weapons.BJPsych bulletin · 2016Article
- "Care or control?": a qualitative study of staff experiences with outpatient commitment orders.Social psychiatry and psychiatric epidemiology · 2016Article
- Effectiveness of Community Treatment Orders: The International Evidence.Canadian journal of psychiatry. Revue canadienne de psychiatrie · 2016Review
- Canadian Studies on the Effectiveness of Community Treatment Orders.Canadian journal of psychiatry. Revue canadienne de psychiatrie · 2016Review
- Residence Conditions on Community Treatment Orders.Canadian journal of psychiatry. Revue canadienne de psychiatrie · 2015Article
- 'Responsible, but Still not a Real Treatment Partner': A Qualitative Study of the Experiences of Relatives of Patients on Outpatient Commitment Orders.Issues in mental health nursing · 2015Article
- Patient, psychiatrist and family carer experiences of community treatment orders: qualitative study.Social psychiatry and psychiatric epidemiology · 2014Article
- The utility of outpatient civil commitment: Investigating the evidence.International journal of law and psychiatryReview
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
3 authors.
Funding
Abstract
purposeCommunity Treatment Orders (CTOs) require outpatients to adhere to treatment and permit rapid hospitalisation when necessary. They have become a clinical and policy solution to repeated hospital readmissions despite some strong opposition and the contested nature of published evidence. In this article, we appraise the current literature on CTOs from the viewpoint of Evidence-Based Medicine and discuss the way forward for using and researching CTOs.
resultsNon-randomised outcome studies show conflicting results, but their lack of standardisation of methods and measures makes it difficult to draw conclusions. In contrast, all three randomised controlled trials (RCTs) conducted concur in their findings that CTOs do not impact on hospital outcomes. No systematic review or meta-analysis has identified any clear clinical advantage to CTOs.
conclusionThe evidence-base does not support the use of CTOs in their current form. Involuntary clinical interventions must conform to the highest standard of evidence-based care. To enable clinicians to take an evidence-based approach and to settle remaining uncertainties about the current evidence, high-quality RCTs should be designed and undertaken, using standardised outcome measures.
Indexed as
Identifiers
24562319What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.