Observational studyPloS one2018
Effectiveness of integrated care including therapeutic assertive community treatment in severe schizophrenia-spectrum and bipolar I disorders: Four-year follow-up of the ACCESS II study.
Observational study in PloS one, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT01888627 (Integrated Care in Patients With a Psychotic Disorder Fulfilling Definition of Severe Mental Illness), which is not on this map. Cited by 26 papers, 2 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.
Integrated Care in Patients With a Psychotic Disorder Fulfilling Definition of Severe Mental Illness (ACCESS-II Study)
Who cites it
26 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- [Evidence on the effects of crisis resolution teams, home treatment and assertive outreach for people with mental disorders in Germany, Austria and Switzerland - a systematic review].Der Nervenarzt · 2022Pooled it
- Defining disengagement from mental health services for individuals experiencing first episode psychosis: a systematic review.Social psychiatry and psychiatric epidemiology · 2019Pooled it
- Assertive Community Treatment and ACT-Derived Outreach Models: A Scoping Review of Adaptations, Fidelity and Outcomes.Community mental health journal · 2026Article
- Preliminary Study of the Effectiveness of the GUIA Assertive Community Treatment Program for the Care of Young, Highly Complex Mental Health Patients.Community mental health journal · 2026Observational
- Associations between readmission and patient-reported measures in acute psychiatric inpatients: a multicenter prospective longitudinal study.Social psychiatry and psychiatric epidemiology · 2025Article
- A Qualitative Investigation of Characteristics Impacting Clinical Decision-Making in Integrated Behavioral Health Care.The journal of behavioral health services & research · 2024Article
- Evaluation of a flexible assertive community treatment (FACT) program for patients with severe mental illness: an observational study in Salzburg, Austria.International journal of mental health systems · 2024Article
- A Scoping Review of Assertiveness Therapy for Reducing Bullying Behavior and Its Impacts Among Adolescents.Journal of multidisciplinary healthcare · 2024Article
- Achieving long-term goals through early personalized management of schizophrenia: expert opinion on the role of a new fast-onset long-acting injectable antipsychotic.Annals of general psychiatry · 2023Review
- Service users' perceptions of relevant and helpful components of an integrated care concept (ACCESS) for psychosis.Frontiers in psychology · 2023Article
- Mediators of quality of life change in people with severe psychotic disorders treated in integrated care: ACCESS II study.European psychiatry : the journal of the Association of European Psychiatrists · 2022Article
- The clinical characterization of the adult patient with bipolar disorder aimed at personalization of management.World psychiatry : official journal of the World Psychiatric Association (WPA) · 2022Article
- Health-related quality of life in severe psychotic disorders during integrated care: 5-year course, prediction and treatment implications (ACCESS II).Health and quality of life outcomes · 2022Article
- Network Analysis of the Brief ICF Core Set for Schizophrenia.Frontiers in psychiatry · 2022Article
- One-Month versus Three-Month Formulation of Paliperidone Palmitate Treatment in Psychotic Disorders: Patients', Relatives', and Mental Health Professionals' Perspectives.Patient preference and adherence · 2022Article
- An Integrated Account of Expert Perspectives on Functioning in Schizophrenia.Journal of clinical medicine · 2021Article
- Article
- [A review of the update of the German S3-guideline on diagnostics and therapy of bipolar disorders 2019].Der Nervenarzt · 2020Review
- [Healthcare research in the living environment].Der Nervenarzt · 2019Review
- Incorporating a Physical Activity Program into an Assertive Community Treatment Team: Impact and Strategies.Community mental health journal · 2019Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
25 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
The ACCESS-model offers integrated care including assertive community treatment to patients with psychotic disorders. ACCESS proved more effective compared to standard care (ACCESS-I study) and was successfully implemented into clinical routine (ACCESS-II study). In this article, we report the 4-year outcomes of the ACCESS-II study. Between May 2007 and December 2013, 115 patients received continuous ACCESS-care. We hypothesized that the low 2-year disengagement and hospitalization rates and significant improvements in psychopathology, functioning, and quality of life could be sustained over 4 years. Over 4 years, only 10 patients disengaged from ACCESS. Another 23 left for practical reasons and were successfully transferred to other services. Hospitalization rates remained low (13.0% in year 3; 9.1% in year 4). Involuntary admissions decreased from 35% in the 2 years prior to ACCESS to 8% over 4 years in ACCESS. Outpatient contacts remained stably high at 2.0-2.4 per week. We detected significant improvements in psychopathology (effect size d = 0.79), illness severity (d = 1.29), level of functioning (d = 0.77), quality of life (d = 0.47) and stably high client satisfaction (d = 0.02) over 4 years. Most positive effects were observed within the first 2 years with the exception of illness severity, which further improved from year 2 to 4. Within continuous intensive 4-year ACCESS-care, sustained improvements in psychopathology, functioning, quality of life, low service disengagement and re-hospitalization rates, as well as low rates of involuntary treatment, were observed in contrast to other studies, which reported a decline in these parameters once a specific treatment model was stopped. Yet, stronger evidence to prove these results is required.
trial registrationClinical Trial Registration Number: NCT01888627.
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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.