Effectiveness of an Evidence-Based Home Care Intervention on Treatment Outcomes for Schizophrenia Patients: A Systematic Review of Randomized Controlled Trials

Authors
Amirhossein Khakbaz
Ali Akbari
Nahid Naseri
Sajad Vosoughi
Nazanin Fard Moghadam
10.61186/ibj.25th-11th-IACRTIMSS
Abstract
Introduction: Schizophrenia is a disabling chronic disorder with a complex and persistent nature that has resulted in limited treatment success. The first-line treatment for these patients has been medication, which has been somewhat successful in controlling symptoms; however, most of these patients require rehospitalization. This review study aimed to examine the effectiveness of evidence-based home care interventions for patients with schizophrenia.

Search Strategy: This is a systematic review conducted in 2024 by analyzing articles from databases such as PubMed, Scopus, Science Direct, Web of Science, Medline, and PsycINFO. Keywords such as "schizophrenia", "evidence-based", "home care", "psychiatric care", "treatment outcome", and "randomized controlled trial" were searched in both English and Persian. The search was conducted from the beginning to March 2024. Initially, 221 studies were identified in the identification stage. Then, 197 articles were excluded in the screening stage, and 41 remained after the eligibility assessment. After further review, 24 articles that met the inclusion criteria were included in the review. The PRISMA checklist was used to enhance the reporting of the findings. Also, all short articles and review articles for which full versions were unavailable for any reason were excluded from the analysis.

Results: Twenty-four randomized controlled trials (RCTs) examined the effectiveness of home-based care (HBC) for individuals with schizophrenia. Findings demonstrated that HBC interventions significantly reduced symptom severity, duration, and readmission rates. Additionally, these interventions led to meaningful improvements in positive, negative, and general psychopathology symptoms one year after discharge. The efficacy of these interventions extended beyond patients to encompass broader aspects, including reduced caregiver burden and healthcare costs. Improved medication adherence, enhanced psychosocial support, and early identification and intervention of relapse were underlying mechanisms of the favorable treatment outcomes.

Conclusion and Discussion: Strong evidence from RCTs demonstrates that home care intervention is a practical and cost-effective treatment intervention for patients with schizophrenia, leading to significant improvements in both clinical and economic outcomes home care intervention should be considered as an alternative or complementary treatment option to traditional hospital-based care.


Keywords
Psychiatry
Schizophrenia
Treatment outcome