Twelve months effect of self-referral to inpatient treatment on patient activation, recovery, symptoms and functioning: A randomized controlled study.

OBJECTIVE: To investigate the effect of having a contract for self-referral to inpatient treatment (SRIT) in patients with severe mental disorders. METHODS: A randomized controlled trial with 53 adult patients; 26 participants received a SRIT contract, which they could use to refer themselves into a Community Mental Health Centre up to five days for each referral without contacting a doctor in advance. Outcomes were assessed after 12 months with the self-report questionnaires Patient Activation Measure (PAM-13), Recovery Assessment Scale (RAS), and the Behavior and Symptom Identification Scale (BASIS-32) and analyzed using linear mixed and regression models. RESULTS: There was no significant effect on PAM-13 (estimated mean difference (emd) -0.41, 95% CI (CI):-7.49-6.67), nor on the RAS (emd 0.02, CI:-0.27-0.31) or BASIS-32 (0.09, CI:-0.28-0.45). An exploratory post hoc analysis showed effect of SRIT in those with low PAM below ≤47 (p=0.049). CONCLUSION: There were no group differences after 12 months, but both groups maintained their baseline levels. PRACTICE IMPLICATIONS: SRIT contracts can be recommended as it supports the rights to self-determination, promote user participation in decision-making in own treatment without any indication of adverse effects.

Characteristics of visitors to homeopaths in a total adult population study in Norway (HUNT 2).

OBJECTIVES: To study the characteristics of people visiting homeopaths in a total adult population in Norway. METHODS: Data from a total population cross sectional health survey conducted in 1995-1997 in Central Norway (HUNT 2) with 65,495 participants. Variables included in the analysis were age, marital status, education, being a social welfare recipient, lifestyle (daily smoker), Hospital Anxiety and Depression Scale (HADS-T), global health perception, self-reported health complaints and a variety of diseases. Significance level p<0.01. RESULTS: 40,027 persons over 20 years answered the question on visits to a homeopath. 4.3% had consulted a homeopath during the last 12 months. The likelihood of a person consulting a homeopath was most strongly associated with being female (adjusted odds ratio 2.3, 95% confidence interval 2.1-2.6) and having a lower perceived global health (increasing from 1.5, 1.2-1.8 for good global health to 2.9, 1.9-4.3 for poor global health). There was a weaker but significant association between increased likelihood of visiting a homeopath and being 30-39 years (1.3, 1.1-1.4), having a HADS-T score between 10-14 (1.3, 1.1-1.6) and 15-19 (1.6, 1.3-2.0), having a health complaint the last year (1.5, 1.2-1.7), hay fever (1.7, 1.5-2.0), consulted for a psychiatric complaint (1.5, 1.3-1.8) and another chronic disease than the ones asked about in this study (1.3, 1.1-1.6). Being a smoker was significantly associated with decreased likelihood of consulting a homeopath (0.7, 0.6-0.7). There was also a trend for increased likelihood of visits to homeopaths (p<0.1) for those 60 years and over, social welfare recipients, having a chronic complaint and HADS-T score of 20 or higher, and decreased likelihood for widow(er)s. CONCLUSIONS AND PROPOSALS: Being female and having a lower perceived global health were the variables most strongly associated with visits to a homeopath. More studies on visits to homeopaths from other populations (countries, children and adolescent) are needed.