Trial reportBMC psychiatry2014
The rise of assertive community interventions in South Africa: a randomized control trial assessing the impact of a modified assertive intervention on readmission rates; a three year follow-up.
Trial report in BMC psychiatry, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers, 3 of them syntheses 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
17 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- Community-based psychosocial interventions for people with schizophrenia in low and middle-income countries: systematic review and meta-analysis.BMC psychiatry · 2017Pooled it
- Intensive case management for severe mental illness.The Cochrane database of systematic reviews · 2017Pooled it
- Effectiveness of quality improvement strategies for coordination of care to reduce use of health care services: a systematic review and meta-analysis.CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne · 2014Pooled it
- Brief Report: A Randomized Control Trial Assessing the Influence of a Telephone-based Intervention on Readmissions for Patients with Severe Mental Illness in a Developing Country.Community mental health journal · 2018Trial
- Assertive Community Treatment and ACT-Derived Outreach Models: A Scoping Review of Adaptations, Fidelity and Outcomes.Community mental health journal · 2026Article
- [Comparative Study of Community-Based Management Models of Schizophrenia at Home and Abroad].Sichuan da xue xue bao. Yi xue ban = Journal of Sichuan University. Medical science edition · 2025Article
- Psychosocial Management of First-Episode Psychosis and Schizophrenia: Synopsis of the US Department of Veterans Affairs and US Department of Defense Clinical Practice Guidelines.Schizophrenia bulletin · 2025Article
- Schizophrenia and schizoaffective disorder: Length of stay and associated factors.The South African journal of psychiatry : SAJP : the journal of the Society of Psychiatrists of South Africa · 2024Article
- Descriptive outcomes for a cohort of high-frequency psychiatric service users in the Western Cape, South Africa after 10 years.The South African journal of psychiatry : SAJP : the journal of the Society of Psychiatrists of South Africa · 2022Article
- Impact of completing a psychosocial rehabilitation programme on inpatient service utilisation in South Africa.The South African journal of psychiatry : SAJP : the journal of the Society of Psychiatrists of South Africa · 2022Article
- Risk factors for readmission among a cohort of psychiatric inpatients in Lilongwe, Malawi.International journal of psychiatry in clinical practice · 2020Article
- Evidence and gap map of studies assessing the effectiveness of interventions for people with disabilities in low-and middle-income countries.Campbell systematic reviews · 2020Article
- Demographic and clinical profile of patients utilising a transitional care intervention in the Western Cape, South Africa.The South African journal of psychiatry : SAJP : the journal of the Society of Psychiatrists of South Africa · 2020Article
- The Role of Communities in Mental Health Care in Low- and Middle-Income Countries: A Meta-Review of Components and Competencies.International journal of environmental research and public health · 2018Review
- Next steps for meeting the needs of people with severe mental illness in low- and middle-income countries.Epidemiology and psychiatric sciences · 2017Article
- Beyond symptom management: Family relations, unmet needs of persons living with severe mental illnesses, and potential implications for social work in South Africa.Social work in health care · 2016Article
- Perceptions of psychosocial disability amongst psychiatric service users and caregivers in South Africa.African journal of disability · 2014Article
Corrections and comments
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Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundMany countries have over the last few years incorporated mental health assertive interventions in an attempt to address the repercussions of deinstitutionalization. Recent publications have failed to duplicate the positive outcomes reported initially which has cast doubt on the future of these interventions. We previously reported on 29 patients from a developing country who completed 12 months in an assertive intervention which was a modified version of the international assertive community treatment model. We demonstrated reduction in readmission rates as well as improvements in social functioning compared to patients from the control group. The obvious question was, however, if these outcomes could be sustained for longer periods of time. This study aims to determine if modified assertive interventions in an under-resourced setting can successfully maintain reductions in hospitalizations.
methodsPatients suffering from schizophrenia who met a modified version of Weidens' high frequency criteria were randomized into two groups. One group received a modified assertive intervention based on the international assertive community treatment model. The other group received standard care according to the model of service delivery in this region. Data was collected after 36 months, comparing readmissions and days spent in hospital.
resultsThe results demonstrated significant differences between the groups. Patients in the intervention group had significantly less readmissions (p = 0.007) and spent less days in hospital compared to the patients in the control group (p = 0.013).
conclusionModified assertive interventions may be successful in reducing readmissions and days spent in hospital in developing countries where standard care services are less comprehensive. These interventions can be tailored in such a way to meet service needs and still remain affordable and feasible within the context of an under-resourced setting.
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