Comparison 1.
CRISIS INTERVENTION vs STANDARD CARE
| Outcome or subgroup title | No. of studies | No. of participants | Statistical method | Effect size |
|---|---|---|---|---|
| 1 Death: 1. Any cause | 6 | 980 | Risk Ratio (M-H, Random, 95% CI) | 0.88 [0.37, 2.07] |
| 2 Death: 2. By cause | 6 | Risk Ratio (M-H, Random, 95% CI) | Subtotals only | |
| 2.1 natural causes | 6 | 980 | Risk Ratio (M-H, Random, 95% CI) | 0.63 [0.18, 2.24] |
| 2.2 suicide or death in suspicious circumstances | 6 | 980 | Risk Ratio (M-H, Random, 95% CI) | 1.06 [0.36, 3.11] |
| 3 Harm to self or others | 5 | Risk Ratio (M-H, Random, 95% CI) | Subtotals only | |
| 3.1 attempted suicide | 3 | 369 | Risk Ratio (M-H, Random, 95% CI) | 2.62 [0.21, 32.02] |
| 3.2 homicide | 3 | 568 | Risk Ratio (M-H, Random, 95% CI) | 2.96 [0.31, 28.28] |
| 4 Hospital use: 1. Unable to keep to initial trial protocol as regards admission | 5 | Risk Ratio (M-H, Random, 95% CI) | Subtotals only | |
| 4.1 by 6 months | 3 | 427 | Risk Ratio (M-H, Random, 95% CI) | 35.76 [6.76, 189.25] |
| 4.2 by 12 months | 5 | 713 | Risk Ratio (M-H, Random, 95% CI) | 51.79 [14.92, 179.86] |
| 4.3 by 20 months | 2 | 306 | Risk Ratio (M-H, Random, 95% CI) | 67.69 [9.48, 483.15] |
| 4.4 by 24 months | 1 | 118 | Risk Ratio (M-H, Random, 95% CI) | 39.77 [2.47, 639.78] |
| 5 Hospital use: 2. Repeat admissions including index admission | 3 | Risk Ratio (M-H, Random, 95% CI) | Subtotals only | |
| 5.1 by 12 months | 3 | 465 | Risk Ratio (M-H, Random, 95% CI) | 0.71 [0.31, 1.61] |
| Participants5.2 by 20 months | 1 | 188 | Risk Ratio (M-H, Random, 95% CI) | 1.10 [0.75, 1.60] |
| 6 Hospital Use: 3. Number of repeat admissions per participant | Other data | No numeric data | ||
| 6.1 By 6 months | Other data | No numeric data | ||
| 7 Hospital use: 4. Repeat admissions excluding index admission | 2 | Risk Ratio (M-H, Random, 95% CI) | Subtotals only | |
| 7.1 by 3 months | 1 | 260 | Risk Ratio (M-H, Random, 95% CI) | 0.53 [0.41, 0.68] |
| 7.2 by 6 months | 2 | 369 | Risk Ratio (M-H, Random, 95% CI) | 0.75 [0.50, 1.13] |
| 8 Hospital use: 5. Repeat admissions excluding index admission - compulsory detentions only | 1 | Risk Ratio (M-H, Random, 95% CI) | Subtotals only | |
| 8.1 by 3 months | 1 | 260 | Risk Ratio (M-H, Random, 95% CI) | 0.62 [0.34, 1.11] |
| 8.2 by 6 months | 1 | 258 | Risk Ratio (M-H, Random, 95% CI) | 0.69 [0.43, 1.11] |
| 9 Hospital use: 6. Treatment failure | 1 | Risk Ratio (M-H, Random, 95% CI) | Subtotals only | |
| 9.1 By 6 months | 1 | 119 | Risk Ratio (M-H, Random, 95% CI) | 3.26 [0.74, 14.44] |
| 10 Hospital use: 7. Days in acute care | 2 | Mean Difference (IV, Random, 95% CI) | Subtotals only | |
| 10.1 By 3 months | 1 | 260 | Mean Difference (IV, Random, 95% CI) | −10.3 [−14.77, −5.83] |
| 10.2 By 6 months | 2 | 365 | Mean Difference (IV, Random, 95% CI) | −10.54 [−26.49, 5.42] |
| 11 Hospital use: 8. Home or outpatient visits (data likely to be skewed) | Other data | No numeric data | ||
| 11.1 6 - 12 months | Other data | No numeric data | ||
| 11.2 by 12 months | Other data | No numeric data | ||
| 12 Leaving the study early (unwilling or unable to provide infomation): 1. Patients | 8 | Risk Ratio (M-H, Random, 95% CI) | Subtotals only | |
| 12.1 by 3 months | 3 | 463 | Risk Ratio (M-H, Random, 95% CI) | 0.80 [0.55, 1.15] |
| 12.2 by 6 months | 5 | 718 | Risk Ratio (M-H, Random, 95% CI) | 0.73 [0.55, 0.97] |
| 12.3 by 12 months | 4 | 594 | Risk Ratio (M-H, Random, 95% CI) | 0.74 [0.56, 0.98] |
| 12.4 by 20 months | 3 | 475 | Risk Ratio (M-H, Random, 95% CI) | 0.78 [0.57, 1.06] |
| 13 Leaving the study early (unwilling or unable to provide information) 2. Relatives | 2 | Risk Ratio (M-H, Random, 95% CI) | Subtotals only | |
| 13.1 total in study | 1 | 120 | Risk Ratio (M-H, Random, 95% CI) | 1.09 [0.52, 2.28] |
| 13.2 subgroup of those living with patient | 1 | 76 | Risk Ratio (M-H, Random, 95% CI) | 0.71 [0.43, 1.17] |
| 14 Global state: 1. GAS (endpoint score, range 1-100, low = poor) (loss in some cases is greater than 30%) | 2 | Mean Difference (IV, Random, 95% CI) | Subtotals only | |
| 14.1 By 3 months | 1 | 27 | Mean Difference (IV, Random, 95% CI) | 0.0 [−12.82, 12.82] |
| 14.2 by 6 months | 1 | 129 | Mean Difference (IV, Random, 95% CI) | 5.10 [−0.86, 11.06] |
| 14.3 by 12 months | 1 | 131 | Mean Difference (IV, Random, 95% CI) | 3.5 [−3.15, 10.15] |
| 14.4 by 20 months | 1 | 142 | Mean Difference (IV, Random, 95% CI) | 5.70 [−0.26, 11.66] |
| 15 Global state: 2. SAS (endpoint score, high = poor) (loss in some cases in greater than 30%) | 1 | Mean Difference (IV, Random, 95% CI) | Subtotals only | |
| 15.1 by 6 months | 1 | 130 | Mean Difference (IV, Random, 95% CI) | −0.20 [−0.75, 0.35] |
| 15.2 by 12 months | 1 | 120 | Mean Difference (IV, Random, 95% CI) | −0.30 [−0.85, 0.25] |
| 15.3 by 20 months | 1 | 139 | Mean Difference (IV, Random, 95% CI) | −0.60 [−1.15, −0.05] |
| 16 Global state: 3. GAS scale change data by 3 months (+ve change = good, data likely to be skewed) | 2 | 156 | Mean Difference (IV, Random, 95% CI) | 4.17 [−1.56, 9.89] |
| 17 Global state: 4. SAS change data by 3 months (−ve change = good, data likely to be skewed) | 1 | 127 | Mean Difference (IV, Random, 95% CI) | −0.09 [−0.31, 0.13] |
| 18 Mental state - general: 1. Unwell by 12 months | 1 | 120 | Risk Ratio (M-H, Random, 95% CI) | 0.65 [0.40, 1.07] |
| 19 Mental state - general: 2. BPRS (endpoint score, range 24-168, high = poor) (loss in standard group >30% for 6 months or more) | 3 | Mean Difference (IV, Random, 95% CI) | Subtotals only | |
| 19.1 by 3 months | 2 | 248 | Mean Difference (IV, Random, 95% CI) | −4.03 [−8.18, 0.12] |
| 19.2 by 6 months | 1 | 129 | Mean Difference (IV, Random, 95% CI) | −2.10 [−6.40, 2.20] |
| 19.3 by 12 months | 1 | 131 | Mean Difference (IV, Random, 95% CI) | −2.0 [−6.03, 2.03] |
| 19.4 by 20 months | 1 | 142 | Mean Difference (IV, Random, 95% CI) | −4.5 [−8.68, −0.32] |
| 20 Mental state - general: 3. PEF (endpoint score, range 0-5, high = poor) (loss is greater than 30%) | 1 | Mean Difference (IV, Random, 95% CI) | Subtotals only | |
| 20.1 by 3 months | 1 | 118 | Mean Difference (IV, Random, 95% CI) | 0.20 [−0.22, 0.62] |
| 20.2 by 6 months | 1 | 111 | Mean Difference (IV, Random, 95% CI) | 0.10 [−0.42, 0.62] |
| 20.3 by 12 months | 1 | 97 | Mean Difference (IV, Random, 95% CI) | −0.40 [−0.84, 0.04] |
| 20.4 by 20 months | 1 | 100 | Mean Difference (IV, Random, 95% CI) | 0.10 [−0.47, 0.67] |
| 21 Mental state - general: 4. PSE (endpoint score, high score = poor, data likely to be skewed) | Other data | No numeric data | ||
| 21.1 by 6 months | Other data | No numeric data | ||
| 21.2 by 12 months | Other data | No numeric data | ||
| 21.3 by 20 months | Other data | No numeric data | ||
| 22 Mental state - general: 5. BPRS scale change data by 3 months (−ve change = good, data likely to be skewed) | 1 | 129 | Mean Difference (IV, Random, 95% CI) | −3.5 [−8.92, 1.92] |
| 23 Mental state - general: 6. PSE scale change data by 3 months (−ve change = good, data likely to be skewed). | 1 | 129 | Mean Difference (IV, Random, 95% CI) | −2.70 [−7.69, 2.29] |
| 24 Mental state: general PANSS (endpoint score, range 30-210, high = poor) | 1 | 111 | Mean Difference (IV, Fixed, 95% CI) | 4.0 [−3.45, 11.45] |
| 24.1 By 6 months | 1 | 111 | Mean Difference (IV, Fixed, 95% CI) | 4.0 [−3.45, 11.45] |
| 25 Mental state - specific: 1. Unsociable (reported by relatives) | 1 | Risk Ratio (M-H, Random, 95% CI) | Subtotals only | |
| 25.1 by 3 months | 1 | 120 | Risk Ratio (M-H, Random, 95% CI) | 0.86 [0.66, 1.12] |
| 25.2 by 6 months | 1 | 120 | Risk Ratio (M-H, Random, 95% CI) | 0.43 [0.30, 0.64] |
| 26 Mental state - specific: 2. Aggression (reported by relatives) | 1 | Risk Ratio (M-H, Random, 95% CI) | Subtotals only | |
| 26.1 by 3 months | 1 | 120 | Risk Ratio (M-H, Random, 95% CI) | 0.97 [0.72, 1.31] |
| 26.2 by 6 months | 1 | 120 | Risk Ratio (M-H, Random, 95% CI) | 0.7 [0.39, 1.25] |
| 27 Mental state - specific: 3. Various problems at 4 months (reported by relatives) | 1 | Risk Ratio (M-H, Random, 95% CI) | Subtotals only | |
| 27.1 agitation | 1 | 120 | Risk Ratio (M-H, Random, 95% CI) | 0.59 [0.36, 0.95] |
| 27.2 depression | 1 | 120 | Risk Ratio (M-H, Random, 95% CI) | 0.8 [0.57, 1.13] |
| 27.3 disorientation | 1 | 120 | Risk Ratio (M-H, Random, 95% CI) | 0.47 [0.28, 0.79] |
| 27.4 psychotic behaviour | 1 | 120 | Risk Ratio (M-H, Random, 95% CI) | 0.58 [0.30, 1.11] |
| 27.5 substance abuse | 1 | 120 | Risk Ratio (M-H, Random, 95% CI) | 0.67 [0.33, 1.36] |
| 27.6 withdrawal | 1 | 120 | Risk Ratio (M-H, Random, 95% CI) | 0.72 [0.48, 1.07] |
| 28 Burden - family: 1. Disruption to daily routine | 2 | Risk Ratio (M-H, Random, 95% CI) | Subtotals only | |
| 28.1 by 3 months | 2 | 220 | Risk Ratio (M-H, Random, 95% CI) | 0.76 [0.59, 0.97] |
| 28.2 by 6 months | 2 | 220 | Risk Ratio (M-H, Random, 95% CI) | 0.67 [0.37, 1.21] |
| 29 Burden - family: 2. Disruption to social life | 2 | Risk Ratio (M-H, Random, 95% CI) | Subtotals only | |
| 29.1 by 3 months | 2 | 220 | Risk Ratio (M-H, Random, 95% CI) | 0.69 [0.53, 0.91] |
| 29.2 by 6 months | 2 | 220 | Risk Ratio (M-H, Random, 95% CI) | 0.72 [0.43, 1.22] |
| 30 Burden - family: 3. Financial strain | 1 | Risk Ratio (M-H, Random, 95% CI) | Subtotals only | |
| 30.1 by 3 months | 1 | 120 | Risk Ratio (M-H, Random, 95% CI) | 0.76 [0.52, 1.10] |
| 30.2 by 6 months | 1 | 120 | Risk Ratio (M-H, Random, 95% CI) | 0.84 [0.53, 1.33] |
| 31 Burden - family: 4. Physical illness due to patient’s illness | 1 | Risk Ratio (M-H, Random, 95% CI) | Subtotals only | |
| 31.1 by 3 months | 1 | 100 | Risk Ratio (M-H, Random, 95% CI) | 0.78 [0.65, 0.95] |
| 31.2 by 6 months | 1 | 100 | Risk Ratio (M-H, Random, 95% CI) | 0.71 [0.55, 0.92] |
| 32 Burden - family: 5. Overall burden is great | 1 | Risk Ratio (M-H, Random, 95% CI) | Subtotals only | |
| 32.1 by 3 months | 1 | 120 | Risk Ratio (M-H, Random, 95% CI) | 0.57 [0.41, 0.80] |
| 32.2 by 6 months | 1 | 120 | Risk Ratio (M-H, Random, 95% CI) | 0.34 [0.20, 0.59] |
| 33 Burden - community: 1. Not employed by 20 months | 1 | 189 | Risk Ratio (M-H, Random, 95% CI) | 0.97 [0.85, 1.12] |
| 34 Burden - community: 1a. In paid work by 6 months | 1 | 112 | Risk Ratio (M-H, Random, 95% CI) | 1.41 [0.65, 3.04] |
| 34.1 By 6 months | 1 | 112 | Risk Ratio (M-H, Random, 95% CI) | 1.41 [0.65, 3.04] |
| 35 Burden - community: 2. Various outcomes by 12 months | 1 | Risk Ratio (M-H, Random, 95% CI) | Subtotals only | |
| 35.1 at least one arrest | 1 | 120 | Risk Ratio (M-H, Random, 95% CI) | 0.71 [0.46, 1.12] |
| 35.2 at least one use of emergency services | 1 | 120 | Risk Ratio (M-H, Random, 95% CI) | 0.81 [0.43, 1.54] |
| 36 Burden - community: 3. Arrested | 1 | 111 | Risk Ratio (M-H, Random, 95% CI) | 5.36 [0.28, 101.35 |
| 36.1 By 6 months | 1 | 111 | Risk Ratio (M-H, Random, 95% CI) | 5.36 [0.28, 101.35] |
| 37 Burden - community: 4. Homelessness | 1 | 113 | Risk Ratio (M-H, Random, 95% CI) | 1.23 [0.59, 2.57] |
| 37.1 By 6 months | 1 | 113 | Risk Ratio (M-H, Random, 95% CI) | 1.23 [0.59, 2.57] |
| 38 Satisfaction - patient: 1. Various outcomes by 12 months | 1 | Risk Ratio (M-H, Random, 95% CI) | Subtotals only | |
| 38.1 feels unimproved | 1 | 119 | Risk Ratio (M-H, Random, 95% CI) | 0.48 [0.31, 0.74] |
| 38.2 dissatisfied with treatment received | 1 | 119 | Risk Ratio (M-H, Random, 95% CI) | 0.66 [0.50, 0.88] |
| 38.3 prefered to get other treatment | 1 | 119 | Risk Ratio (M-H, Random, 95% CI) | 0.46 [0.27, 0.77] |
| 38.4 feels less able to cope | 1 | 119 | Risk Ratio (M-H, Random, 95% CI) | 0.36 [0.21, 0.62] |
| 38.5 feels will need more help outside working hours in the future | 1 | 119 | Risk Ratio (M-H, Random, 95% CI) | 1.48 [0.88, 2.48] |
| 39 Satisfaction - patient: 2. Patient satisitfied with care: Satisfaction Scale (endpoint score, range 0 −32, low = poor) | 2 | Mean Difference (IV, Random, 95% CI) | Subtotals only | |
| 39.1 by 3 months | 1 | 226 | Mean Difference (IV, Random, 95% CI) | 1.60 [−0.22, 3.42] |
| 39.2 by 6 months | 1 | 115 | Mean Difference (IV, Random, 95% CI) | 5.10 [3.16, 7.04] |
| 39.3 by 12 months | 1 | 121 | Mean Difference (IV, Random, 95% CI) | 4.80 [3.11, 6.49] |
| 39.4 by 20 months | 1 | 137 | Mean Difference (IV, Random, 95% CI) | 5.40 [3.91, 6.89] |
| 40 Satisfaction: Patient: 3. VSSS Scale (low = poor) | 1 | 24 | Mean Difference (IV, Random, 95% CI) | 0.20 [−0.20, 0.60] |
| 41 Satisfaction - relatives: 1. Feels patient is not improved | 1 | Risk Ratio (M-H, Random, 95% CI) | Subtotals only | |
| 41.1 by 3 months | 1 | 120 | Risk Ratio (M-H, Random, 95% CI) | 0.79 [0.60, 1.04] |
| 41.2 by 6 months | 1 | 120 | Risk Ratio (M-H, Random, 95% CI) | 0.71 [0.53, 0.97] |
| 42 Satisfaction - relatives: 4. Various outcomes by 12 months | 1 | Risk Ratio (M-H, Random, 95% CI) | Subtotals only | |
| 42.1 feel themselves less able to cope | 1 | 120 | Risk Ratio (M-H, Random, 95% CI) | 0.57 [0.42, 0.78] |
| 42.2 feel themsleves to need more help outside working hours in the future | 1 | 120 | Risk Ratio (M-H, Random, 95% CI) | 1.21 [0.91, 1.60] |
| 43 Satisfaction - relatives: 3. Would have preferred patient to have received other treatment | 1 | Risk Ratio (M-H, Random, 95% CI) | Subtotals only | |
| 43.1 by 3 months | 1 | 120 | Risk Ratio (M-H, Random, 95% CI) | 1.27 [0.63, 2.57] |
| 43.2 by 6 months | 1 | 120 | Risk Ratio (M-H, Random, 95% CI) | 1.11 [0.49, 2.54] |
| 43.3 by 12 months | 1 | 120 | Risk Ratio (M-H, Random, 95% CI) | 0.81 [0.43, 1.54] |
| 44 Satisfaction - relatives: 2. Dissatisfied with treatment received | 1 | Risk Ratio (M-H, Random, 95% CI) | Subtotals only | |
| 44.1 by 3 months | 1 | 120 | Risk Ratio (M-H, Random, 95% CI) | 0.63 [0.44, 0.89] |
| 44.2 by 6 months | 1 | 120 | Risk Ratio (M-H, Random, 95% CI) | 0.57 [0.42, 0.78] |
| 44.3 by 12 months | 1 | 120 | Risk Ratio (M-H, Random, 95% CI) | 0.46 [0.29, 0.72] |
| 45 Economic cost per patient (data likely to be skewed) | Other data | No numeric data | ||
| 45.1 total cost for trial period - as assessed by researchers | Other data | No numeric data | ||
| 45.2 total cost for trial period - as assessed by finance department | Other data | No numeric data | ||
| 45.3 per week | Other data | No numeric data | ||
| 46 Quality of Life MANSA patient endpoint score, range 0 - 88, low = poor | 1 | 226 | Mean Difference (IV, Random, 95% CI) | −1.5 [−5.15, 2.15] |
| 47 Quality of Life MANSA-short form patient endpoint score, low = poor | 1 | 28 | Mean Difference (IV, Random, 95% CI) | 0.70 [0.14, 1.26] |
| 48 Quality of life: EQ-5D range 0 to 1, low = poor | 1 | 26 | Mean Difference (IV, Fixed, 95% CI) | 0.01 [−0.32, 0.34] |
| 48.1 By 3 months | 1 | 26 | Mean Difference (IV, Fixed, 95% CI) | 0.01 [−0.32, 0.34] |
| 49 Social contacts | 1 | 107 | Mean Difference (IV, Random, 95% CI) | 0.43 [−0.30, 1.16] |
| 49.1 By 6 months | 1 | 107 | Mean Difference (IV, Random, 95% CI) | 0.43 [−0.30, 1.16] |
| 50 Social functioning: LSP-staff endpoint score, range 0-156, low = poor | 1 | Mean Difference (IV, Random, 95% CI) | Subtotals only | |
| 50.1 by 3 months | 1 | 260 | Mean Difference (IV, Random, 95% CI) | 3.0 [−0.72, 6.72] |
| 50.2 by 6 months | 1 | 260 | Mean Difference (IV, Random, 95% CI) | 1.0 [−2.76, 4.76] |
| 51 Clinical and social problems HoNOS - staff endpoint score, range 0-48, high = poor | 1 | Mean Difference (IV, Random, 95% CI) | Subtotals only | |
| 51.1 by 3 months | 1 | 257 | Mean Difference (IV, Random, 95% CI) | −1.90 [−3.20, −0.60] |
| 51.2 by 6 months | 1 | 255 | Mean Difference (IV, Random, 95% CI) | −0.60 [−2.07, 0.87] |
| 52 Unmet needs: CAN scale range 0-22, high = poor | Other data | No numeric data |