Evidence map›Paper›PMID 34238042›Full record

Trial reportJournal of primary care & community health

The Long-Term Effects of a Housing First Intervention on Primary Care and Non-Primary Care Physician Visits Among Homeless Adults with Mental Illness: A 7-Year RCT Follow-Up.

Cilia Mejia-Lancheros, James Lachaud, Matthew J To, Patsy Lee, Rosane Nisenbaum, Patricia O'Campo, Vicky Stergiopoulos, Stephen W Hwang

Open access · goldAbstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Journal of primary care & community health. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
0.9field-weighted citation impact, top 21% of its field
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 4 citations in OpenAlex.

  1. Trial
  2. Review
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 4 institutions in 2 countries.

Cilia Mejia-LancherosMAP Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, St Michael's Hospital, Unity Health Toronto, Toronto, ON, Canada.ORCID 0000-0003-1131-8439
James LachaudMAP Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, St Michael's Hospital, Unity Health Toronto, Toronto, ON, Canada.
Matthew J ToSt Joseph's Health Centre, Department of Family and Community Medicine, Unity Health Toronto, Toronto, ON, Canada.
Patsy LeeMcMaster University, Michael G. DeGroote School of Medicine, Hamilton, ON, Canada.
Rosane NisenbaumMAP Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, St Michael's Hospital, Unity Health Toronto, Toronto, ON, Canada.
Patricia O'CampoMAP Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, St Michael's Hospital, Unity Health Toronto, Toronto, ON, Canada.
Vicky StergiopoulosCentre for Addiction and Mental Health, Toronto, ON, Canada.
Stephen W HwangMAP Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, St Michael's Hospital, Unity Health Toronto, Toronto, ON, Canada.
St. Michael's Hospital · CACentre for Addiction and Mental Health · CAMcMaster University · CASt Joseph's Health Centre · CA

Funding

CIHR MOP-130405
6 · The paper itself

Abstract

backgroundHousing First (HF)-based interventions have been implemented in North America and beyond to help people exit homelessness. The effect of these interventions on access to primary and specialist care services is not well-defined. This study assesses the long-term effects of an HF intervention for homeless adults with mental illness on primary care physician (PCP) and non-primary care physician (non-PCP) visits.

methodsThis is a secondary analysis of the At Home/Chez Soi study, a randomized trial of HF for homeless adults with mental illness in Toronto, Canada. High-need (HN) participants were randomized to HF with assertive community treatment (HF-ACT) or treatment as usual (TAU). Moderate needs (MN) participants were randomized to HF with intensive case management (HF-ICM) or TAU. The primary outcomes were the incidence and the number of visits to a PCP and non-PCP over 7-years post-randomization, compared to the 1-year pre-randomization.

resultsOf 575 enrolled participants, 527 (80 HN and 347 MN) participants were included in the analyses. HN participants who received HF-ACT had a significant reduction in the number of visits to a PCP compared to TAU participants (ratio of rate ratios (RRR): 0.66, 95% CI: 0.48-0.93) and a significant reduction in the number of non-PCP visits compared with TAU participants (RRR: 0.64, 95% CI: 0.42-0.97) in the 7-years post-randomization compared to the 1-year pre-randomization. MN participants who received HF-ICM had a significant increase in incident visits to a PCP compared to TAU participants (RRR: 1.66, 95% CI: 1.10-2.50). No effect of HF-ICM was observed on the incidence or number of non-PCP visits.

conclusionHF has differing effects on visits to PCPs and non-PCPs among homeless people with high and moderate needs for mental health supports. HF does not result in a consistent increase in PCP and non-PCP visits over a 7-year follow-up period. The At Home/Chez Soi study is registered with ISRCTN (ISRCTN, ISRCTN42520374).

Indexed as

Ill-Housed PersonsMental DisordersAdultCanadaFollow-Up StudiesHousingHumansPrimary Health Carehomelessnesshousing firstmental illnessprimary carespecialist physician care

Identifiers

PMID34238042
PMCPMC8274120
OpenAlexW3179288377

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

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.