Johnson Kiersten L, Parish William J, Theis Elysha, Van Dorn Richard A, Callahan Lisa, Swanson Jeffrey W, Swartz Marvin S
RTI International Research Triangle Park North Carolina USA.
Policy Research Associates, Inc. Delmar New York USA.
Psychiatr Res Clin Pract. 2025 May 2;7(3):174-181. doi: 10.1176/appi.prcp.20240162. eCollection 2025 Fall.
This study used data from a multi-site evaluation of six assisted outpatient treatment (AOT) programs to assess the effectiveness of AOT on treatment adherence, clinical functioning, and social functioning outcomes.
Sites provided primary data (e.g., structured client interviews across multiple timepoints) and subsets of secondary data on Medicaid/non-Medicaid service encounters, local/state arrest records, and public/private hospitalizations. One of the six sites provided primary data for a comparison population. Pre-post analyses pooled data across each of the six AOT sites and incorporated robustness checks using comparison and secondary data.
Among 392 AOT clients, appointment and treatment adherence increased by more than 24% and 20%, respectively, in 6- and 12-month follow-up windows relative to baseline. Symptomology, perceived mental health ratings, life satisfaction, and therapeutic alliance scores all improved significantly. Violent behavior was reduced by more than 19%, and suicidal ideation decreased by more than 24%. There was more than a 40% reduction in the percentage of clients with any psychiatric inpatient episodes, and more than an 8-night reduction in the number of nights spent in psychiatric inpatient care. The proportion of clients with arrests decreased by more than 19%, those with any illicit drug use decreased by more than 14%, and in the 6 months following entry into AOT, there was a 12% reduction in the proportion of clients experiencing any homelessness.
Findings point to significant improvements across a range of client outcomes upon receipt of AOT, spanning domains of treatment adherence, clinical functioning, and social functioning outcomes.
本研究使用了对六个辅助门诊治疗（AOT）项目进行多地点评估的数据，以评估AOT在治疗依从性、临床功能和社会功能结果方面的有效性。
各地点提供了原始数据（例如，在多个时间点对客户进行的结构化访谈）以及关于医疗补助/非医疗补助服务接触、地方/州逮捕记录和公立/私立医院住院情况的二级数据子集。六个地点之一提供了用于对照人群的原始数据。前后分析汇总了六个AOT地点各自的数据，并使用对照数据和二级数据进行了稳健性检验。
在392名AOT客户中，在6个月和12个月的随访期内，预约和治疗依从性相对于基线分别提高了24%以上和20%以上。症状、感知心理健康评分、生活满意度和治疗联盟得分均有显著改善。暴力行为减少了19%以上，自杀意念减少了24%以上。有任何精神科住院记录的客户比例减少了40%以上，精神科住院护理的天数减少了8天以上。被捕客户的比例减少了19%以上，有任何非法药物使用行为的客户比例减少了14%以上，并且在进入AOT后的6个月内，经历过无家可归的客户比例减少了12%。
研究结果表明，接受AOT后，一系列客户结果有显著改善，涵盖治疗依从性、临床功能和社会功能结果等领域。
