Factors Influencing Rehospitalisation of Patients with Schizophrenia in Japan: A 1-year Longitudinal Study.
Takeshi Shimada, Ai Nishi, Tomotaka Yoshida and 2 others
PMID 30186062WHAT IT FOUND
In 44 discharged patients with schizophrenia, a one-to-one OT package of motivational interviewing, self-monitoring, individualized visits, handicraft activities, individualized psychoeducation, and discharge planning plus group OT and outpatient adherence were associated with lower 1-year rehospitalisation.
The study cannot show which parts caused this.
Key findings
0144 patients were analysed; 14 were rehospitalised within 1 year after discharge.
02Patients who were not rehospitalised received more IOT during their hospital stay and had better adherence to outpatient treatment and medication.
03In the adjusted logistic analysis, the type of OT intervention and adherence to outpatient treatment and medication were significant factors associated with rehospitalisation.
STILL TO COME
How it was doneWhat they foundWhat it means for OTs
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What it does not show
The study analysed only 44 patients from a single site, so it is small and may not apply to other settings. OT groups were not randomised; patients had chosen GOT plus IOT or GOT alone in the earlier study, so healthier or more motivated patients may have selected IOT. The paper cannot separate the effect of IOT from GOT or from other support, because IOT was a package of several components. Follow-up was only 1 year, and long-term inpatients were excluded. The logistic model included only factors that were already significant in univariate analysis, so other relevant factors may have been missed. The confidence intervals for the odds ratios were very wide, so the size of the association is uncertain.
The easy way to misread this
Do not read this as proof that individualized OT alone prevents rehospitalisation. The study was observational, the OT package had several components, and the groups were not randomised. It only shows that the type of OT intervention and adherence to outpatient treatment and medication were associated with rehospitalisation.