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Social Psychiatry and Psychiatric Epidemiology

Erschienen in:

01.12.2014 | Invited Reviews

CTOs: what is the state of the evidence?

verfasst von: Jorun Rugkåsa, John Dawson, Tom Burns

Erschienen in: Social Psychiatry and Psychiatric Epidemiology | Ausgabe 12/2014

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Abstract

Purpose

Community Treatment Orders (CTOs) require outpatients to adhere to treatment and permit rapid hospitalisation when necessary. They have become a clinical and policy solution to repeated hospital readmissions despite some strong opposition and the contested nature of published evidence. In this article, we appraise the current literature on CTOs from the viewpoint of Evidence-Based Medicine and discuss the way forward for using and researching CTOs.

Results

Non-randomised outcome studies show conflicting results, but their lack of standardisation of methods and measures makes it difficult to draw conclusions. In contrast, all three randomised controlled trials (RCTs) conducted concur in their findings that CTOs do not impact on hospital outcomes. No systematic review or meta-analysis has identified any clear clinical advantage to CTOs.

Conclusion

The evidence-base does not support the use of CTOs in their current form. Involuntary clinical interventions must conform to the highest standard of evidence-based care. To enable clinicians to take an evidence-based approach and to settle remaining uncertainties about the current evidence, high-quality RCTs should be designed and undertaken, using standardised outcome measures.

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Titel: CTOs: what is the state of the evidence?
verfasst von: Jorun Rugkåsa
John Dawson
Tom Burns
Publikationsdatum: 01.12.2014
Verlag: Springer Berlin Heidelberg
Erschienen in: Social Psychiatry and Psychiatric Epidemiology / Ausgabe 12/2014
Print ISSN: 0933-7954
Elektronische ISSN: 1433-9285
DOI: https://doi.org/10.1007/s00127-014-0839-7

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CTOs: what is the state of the evidence?

Abstract

Purpose

Results

Conclusion

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