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Community treatment orders: Clinical and social outcomes, and a subgroup analysis from the OCTET RCT

Rugkåsa, J.; Molodynski, A.; Yeeles, K.; Vazquez Montes, M.; Visser, C.; Burns, T.; (K Canvin), OCTET Group

Authors

J. Rugkåsa

A. Molodynski

K. Yeeles

M. Vazquez Montes

C. Visser

T. Burns



Contributors

J. Rugkåsa
Other

A. Molodynski
Other

K. Yeeles
Other

M. Vazquez Montes
Other

C. Visser
Other

T. Burns
Other

C. Bennett
Other

K. Burns
Other

T. Burns
Other

J. Dawson
Other

M. Dunn
Other

A. Gray
Other

L. Johnston
Other

N. Lewis
Other

S. Masson
Other

A. Molodynski
Other

L. Murray
Other

H. Nightingale
Other

R. Patel
Other

S. Priebe
Other

S. Puntis
Other

L. Russell
Other

A. Ryan
Other

J. Simon
Other

J. Sinclair
Other

T. Smith
Other

A. Sulman
Other

L. Turnpenny
Other

A. Mitchell
Other

M.V. Montes
Other

F. Vergunst
Other

C. Visser
Other

S. Wood-Ganz
Other

M. Voysey
Other

K. Yeeles
Other

Abstract

Objective
Despite widespread use internationally, there is no convincing evidence that community treatment orders (CTO) (legal regimes making out-patient treatment compulsory), reduce readmission rates or have wider patient benefit. The primary and secondary outcomes of the Oxford Community Treatment Order Evaluation Trial (OCTET) (hospitalisation) showed no benefit. This article will, first, test the effect of community compulsion on wider clinical and social outcomes and on patients' experiences of services and the use of treatment pressure and second, explore differential effects in different groups of patients.

Method
OCTET is a RCT of CTO effectiveness. Three hundred and thirty-six patients were randomised and data for the 333 eligible patients were collected from interviews and medical records at baseline, 6 and 12 months.

Results
There was no significant difference at 12 months between the two arms in any of the reported outcomes, except a small difference in patients' view of the effectiveness of treatment pressure, which is unlikely to be clinically meaningful. Two statistically significant interactions were found in the subgroup analysis: symptoms interacted with age and with education, but no pattern was demonstrated.

Conclusion
CTOs do not have benefit on any of the tested outcomes, or for any subgroup of patients. Their continued use should be carefully reconsidered.

Citation

Rugkåsa, J., Molodynski, A., Yeeles, K., Vazquez Montes, M., Visser, C., Burns, T., & (K Canvin), O. G. (2015). Community treatment orders: Clinical and social outcomes, and a subgroup analysis from the OCTET RCT. Acta psychiatrica Scandinavica, 131(5), 321-329. https://doi.org/10.1111/acps.12373

Journal Article Type Article
Online Publication Date Dec 11, 2014
Publication Date 2015-05
Deposit Date Mar 8, 2024
Journal Acta Psychiatrica Scandinavica
Print ISSN 0001-690X
Publisher Wiley
Peer Reviewed Peer Reviewed
Volume 131
Issue 5
Pages 321-329
DOI https://doi.org/10.1111/acps.12373
Publisher URL https://onlinelibrary.wiley.com/doi/10.1111/acps.12373


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