Drukker Marjan, Visser Ellen, Sytema Sjoerd, van Os Jim
Department of Psychiatry and Psychology, School for Mental Health and Neuroscience MHeNS, Maastricht University, p.o. box 616, Location Vijverdal, 6200 MD, Maastricht, the Netherlands.
Department of Psychiatry, University Medical Centre Groningen, University of Groningen, Rob Giel Centre, p.o. box 30.001, 9700 RB Groningen, the Netherlands.
Clin Pract Epidemiol Ment Health. 2013 Nov 28;9:202-9. doi: 10.2174/1745017901309010202. eCollection 2013.
Introduction of Flexible Assertive Community Treatment (FACT) may be associated with increased remission rates and changes in patterns of care. The present paper reports on differences in psychosocial functioning and health care use between patients in FACT and two groups of patients not currently provided with a specific model of community service.
The ongoing "Pharmacotherapy Monitoring and Outcome Survey" provided routine outcome measures of patients using antipsychotics in the north of the Netherlands. Level of psychosocial functioning was assessed using the Health of the Nations Outcome Scales (HoNOS) and matched with psychiatric health care consumption obtained from the Psychiatric Case Register. Patients who never received FACT, patients ever in FACT but not at assessment date, and patients in FACT were identified. Data were subjected to multilevel linear regression analysis.
Data showed that most patients in FACT also had non-FACT episodes after the start of FACT. Furthermore, patients in FACT displayed higher levels of psychosocial functioning and used more outpatient care than the other two groups.
Patients in FACT receive more outpatient care and have better psychosocial functioning. However, causal inferences cannot be derived from these data. In addition, membership of a FACT-team in this setting did not last indefinitely.
引入灵活的积极社区治疗（FACT）可能与缓解率提高及护理模式变化有关。本文报告了FACT患者与两组目前未接受特定社区服务模式的患者在心理社会功能和医疗保健使用方面的差异。
正在进行的“药物治疗监测与结果调查”提供了荷兰北部使用抗精神病药物患者的常规结果测量。使用国家健康结果量表（HoNOS）评估心理社会功能水平，并与从精神病病例登记处获得的精神卫生保健消费情况相匹配。确定从未接受过FACT的患者、曾经接受过FACT但在评估日期未接受的患者以及FACT中的患者。数据进行了多水平线性回归分析。
数据显示，大多数FACT患者在开始FACT治疗后也有未接受FACT治疗的阶段。此外，FACT中的患者心理社会功能水平更高，门诊护理使用比其他两组更多。
FACT中的患者接受更多门诊护理，心理社会功能更好。然而，不能从这些数据得出因果推论。此外，在这种情况下，FACT团队的成员资格并非无限期持续。
