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Medical Journal of Islamic Republic of Iran، جلد ۲۹، شماره ۱، صفحات ۳۰۳-۳۱۱
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عنوان انگلیسی Clinical outcomes and cost effectiveness of two aftercare models provided by general physicians and nurses to patients with severe mental illness
چکیده انگلیسی مقاله Background: Implementing community-based psychiatric services is one of the priorities of the WHO/EMRO mental health programs. This study presents an aftercare service, as a community based-service, for patients with severe mental illness (SMIs). Methods : In this randomized controlled clinical trial design, 176 patients, who attended selective hospitals with SMI, were allocated into three groups: clinical case managers provided by general practitioners, nurses and the control group (usual treatment). The clients and their caregivers received monthly home visits (education and treatment supervision). The effectiveness of the intervention was measured by indicators of psychopathology such as scores of YOUNG, caregivers’ knowledge and satisfaction with the services. Health-related quality of life (SF-36) was considered as the primary outcome variable. Data were collected at baseline and at 12 months follow-up. Direct and indirect medical costs were obtained through a periodic completion of questionnaires and interviews by caregivers. Cost effectiveness ratio was estimated as cost per QALY gained in each group. SPSS 16.0 was used in this survey and statistical methods were chi-square, ANOVA, Scheffe as post-Hoc test and paired sample t-test with 95% confidence interval and 0.05 significance level. Results : The results of our study revealed that the score of YOUNG, caregivers’ knowledge and satisfaction with service were improved in both intervention groups after 12 months. Improvement in health-related quality of life was observed in the general practitioner and nurse group. The incremental cost effectiveness ratio was 5740807 IRR and 5048459 IRR per QALYs gained in the general practitioner and nurse groups, respectively. Conclusion : The model of aftercare services provided by trained nurses is the most cost- effective and feasible model for Iran’s socio-economic conditions with low resource allocations.
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نویسندگان مقاله سید کاظم ملکوتی | seyed kazem malakouti
mental health research centre, tehran psychiatric institute, faculty of behavioral sciences and mental health, iran university of medical sciences, tehran, iran.

سازمان اصلی تایید شده: دانشگاه علوم پزشکی ایران (Iran university of medical sciences)

آرش میراب زاده | arash mirabzadeh
department of psychiatry, university of social welfare and rehabilitation sciences, tehran, iran.

سازمان اصلی تایید شده: دانشگاه علوم بهزیستی و توانبخشی (University of social welfare and rehabilitation sciences)

مرضیه نجومی | marzieh nojomi
department of community medicine; mental health research centre, iran university of medical sciences, tehran, iran.

سازمان اصلی تایید شده: دانشگاه علوم پزشکی ایران (Iran university of medical sciences)

علی احمدی تنکابنی | ali ahmadi tonkaboni
mental health research centre, tehran psychiatric institute; faculty of behavioral sciences and mental health, iran university of medical sciences, tehran, iran.

سازمان اصلی تایید شده: دانشگاه علوم پزشکی ایران (Iran university of medical sciences)

فرانک ندرخانی | faranak nadarkhani
mental health research centre, tehran psychiatric institute, faculty of behavioral sciences and mental health, iran university of medical sciences; tehran, iran.

سازمان اصلی تایید شده: دانشگاه علوم پزشکی ایران (Iran university of medical sciences)

مصلح میرزایی | mosleh mirzaie
mental health research centre, tehran psychiatric institute, faculty of behavioral sciences and mental health, iran university of medical sciences, tehran, iran.

سازمان اصلی تایید شده: دانشگاه علوم پزشکی ایران (Iran university of medical sciences)

نرگس چیمه | narges chimeh
family research institute, shahidbeheshti university, tehran, iran.
نشانی اینترنتی http://mjiri.iums.ac.ir/browse.php?a_code=A-10-1-813&slc_lang=en&sid=en
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