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Hassiotis, Angela, Kouroupa, Athanasia, Hamza, Leila, Marston, Louise, Romeo, Renee, Yaziji, Nahel, Hall, Ian, Langdon, Peter E. 
ORCID: https://orcid.org/0000-0002-7745-1825, Courtenay, Ken, Taggart, Laurence, Morant, Nicola, Crossey, Vicky and Lloyd-Evans, Brynmor
(2023)
Clinical and cost evaluation of two models of specialist intensive support teams for adults with intellectual disabilities who display behaviours that challenge: the IST-ID mixed-methods study.
BJPsych Open, 9 (4).
ISSN 2056-4724
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Abstract
Background: Intensive support teams (ISTs) are recommended for individuals with intellectual disabilities who display behaviours that challenge. However, there is currently little evidence about the clinical and cost-effectiveness of IST models operating in England. Aims: To investigate the clinical and cost-effectiveness of IST models. Method: We carried out a cohort study to evaluate the clinical and cost-effectiveness of two previously identified IST models (independent and enhanced) in England. Adult participants (n = 226) from 21 ISTs (ten independent and 11 enhanced) were enrolled. The primary outcome was change in challenging behaviour between baseline and 9 months as measured by the Aberrant Behaviour Checklist-Community version 2. Results: We found no statistically significant differences between models for the primary outcome (adjusted β = 4.27; 95% CI −6.34 to 14.87; P = 0.430) or any secondary outcomes. Quality-adjusted life-years (0.0158; 95% CI: −0.0088 to 0.0508) and costs (£3409.95; 95% CI −£9957.92 to £4039.89) of the two models were comparable. Conclusions: The study provides evidence that both models were associated with clinical improvement for similar costs at follow-up. We recommend that the choice of service model should rest with local services. Further research should investigate the critical components of IST care to inform the development of fidelity criteria, and policy makers should consider whether roll out of such teams should be mandated.
| Item Type: | Article |
|---|---|
| Additional Information: | Funding information: This project is funded by the National Institute for Health Research (NIHR) Health Services and Delivery Research (HS&DR) programme (reference number 16/01/24). The views expressed are those of the authors and not necessarily those of the NIHR or the Department of Health and Social Care. A full version of the IST-ID study that this is part of has been published in https://www.journalslibrary.nihr.ac.uk/hsdr/CHDC1642/#/full-report. |
| Uncontrolled Keywords: | intellectual disability,cost-effectiveness,developmental disorders,intensive support,outcome studies,psychiatry and mental health ,/dk/atira/pure/subjectarea/asjc/2700/2738 |
| Faculty \ School: | Faculty of Medicine and Health Sciences > Norwich Medical School |
| Related URLs: | |
| Depositing User: | LivePure Connector |
| Date Deposited: | 25 Jul 2023 15:30 |
| Last Modified: | 03 Aug 2023 08:31 |
| URI: | https://ueaeprints.uea.ac.uk/id/eprint/92694 |
| DOI: | 10.1192/bjo.2023.74 |
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