Table 2.

Quality assessment of included studies

Study	1. Did the study address a clearly focused issue?	2. Was the cohort recruited in an acceptable way?	3. Was exposure accurately measured to minimize bias?	4. Was the outcome accurately measured to minimize bias?	5a. Have authors identified all important confounds?	5b. Have they taken account on the confounds in the design/analysis?	6a. Was the follow-up of subjects complete?	6b. Was the follow-up of subjects long enough?	7. What are the results of this study?	8. How precise are the results?	9. Do you believe the results?	10. Can the results be applied to the local population?	11. Do the results of this study fit with other available evidence?	12. What are the implications of this study for practice?	Rating
CASP checklist cohort studies:
Dibben et al20	Yes	Yes	Yes	Yes	Yes	Yes	Yes	Yes	Admissions reduced by 31% General trend for greater satisfaction in carers and service users No difference in involuntary admissions No odds ratios	Quite	Yes	Yes within reason – all health care contexts are different	Yes	Recommendation of use of CRHTT for older people	+
Ginsburg and Eng21	Yes	Yes	Yes	Yes	No mention of what common mental disorders are experienced Number of ppts with dementia not reported	No	Yes	Yes	Increased access to mental health services Reduction in admissions and psychiatric bed days High staff satisfaction with treatment	Not very	Yes	Potentially, in supported living environments	Not a lot of other evidence is discussed in relation to the findings	Mental health professionals should be a part of integrated living teams	0
Doyle and Varian18	Yes	Yes	Yes	Yes	Yes	Yes	Yes	Yes	Patients in long stay hospital beds similar for both groups Both services good at predicting when hospitalization needed and mobilizing support to prevent further admissions More people in residential care in office hours group – although more residential care also available in this group	Good	Yes	Yes	Yes	Crisis teams operating within office hours can be as effective as 24-hour teams	++
Richman et al19	Yes	Yes	Yes	Yes	No control group identified	No control group	Yes	Yes	30 admissions to inpatient psychiatric care were avoided through the establishment of this team.	Quite	Yes	Yes in areas where CMHT exists but domiciliary crisis services do not	Yes	This kind of intervention may reduce admission to inpatient psychiatric care	0
Ratna17	Yes	Yes	Yes	Not known	Yes	Yes	Yes	Yes	The population seen in crisis was similar to that referred to other services Assessments made in the home are as effective in determining who should go to hospital and who can be managed in the community This model is effective at stabilizing patients to enable care in the community	Good	Yes	Yes – but few areas would be able to support a 24-hour crisis service	Yes	Crisis services are able to support people at home	+
Villars et al22	Yes	Yes	Yes	Yes	Yes	Analyses have not differentiated between severe and mild dementia	Yes	No	No significant differences in early ER rehospitalization	Quite	Yes	Yes	Yes	This type of intervention was welcomed by families and nurses but did not prevent or reduce rehospitalization	+

Study	1. Did the study address a clearly focused issue?	2. Did the authors use an appropriate method to answer their question?	3. Were the cases recruited in an acceptable way?	4. Were the controls selected in an acceptable way?	5. Was exposure accurately measured to minimize bias?	6a. What confounding factors have the authors accounted for?	6b. Have the authors taken account of the potential confounds in design/analysis?	7. What are the results of this study?	8. How precise are the results?	9. Do you believe the results?	10. Can the results be applied to the local population?	11. Do the results of this study fit with other available evidence?	Rating
CASP checklist case–control studies:
Johnson et al23	Yes	Yes	Yes	Yes	Yes	Differences between control and intervention groups No reporting of participants family situation	No statistical adjustment	Reduction in NP symptoms, 79% resolution in crisis, less hospital admissions than control group, delayed nursing home placement	Quite – no confidence intervals and no reporting of ppts who declined	Yes	Can be applied in areas where complete lack of services. Not sure how well these findings integrate into UK health system	Yes	+

Abbreviations: CASP, Critical Appraisal Skills Programme Centre; CRHTT, crisis resolution home treatment team; CMHT, community mental health team; ER, emergency room; NP, neuropsychiatric; ppts, patients.