Randomized Clinical Trial of the Effectiveness of a Home-Based Advanced Practice Psychiatric Nurse Intervention: Outcomes for Individuals with Serious Mental Illness and HIV
2011

Home-Based Care for Mental Illness and HIV

Sample size: 238 publication 10 minutes Evidence: moderate

Author Information

Author(s): Nancy P. Hanrahan, Evan Wu, Deena Kelly, Linda H. Aiken, Michael B. Blank

Primary Institution: University of Pennsylvania

Hypothesis

Patients receiving the home-based APRN intervention would have experienced greater improvements in symptoms and quality of life than the control group.

Conclusion

The study found that care management by advanced practice psychiatric nurses can improve symptoms and health-related quality of life for individuals with serious mental illness and HIV.

Supporting Evidence

  • Participants receiving a high dose of APRN intervention showed significant reductions in psychiatric symptoms.
  • The intervention group had better health-related quality of life outcomes compared to the control group.
  • Care management by APRNs may be a more efficient approach for high-risk populations.
  • Participants in the high-dose category experienced an average decrease in PHQ-9 score of 5.314 points.
  • High-dose participants showed consistent reductions in CSI scores at each time point.

Takeaway

This study shows that special nurses can help people with serious mental health issues and HIV feel better and live healthier lives.

Methodology

A longitudinal randomized controlled trial with an intervention group receiving home-based services from advanced practice nurses and a control group receiving usual care.

Potential Biases

Unequal randomization probabilities and potential indirect bias due to the involvement of research assistants in both groups.

Limitations

The study may not reflect outcomes from community-based nurses and the control group received repeated interviews, which could influence results.

Participant Demographics

Participants were primarily HIV-positive individuals with serious mental illness, aged 18 or older, living in Philadelphia.

Statistical Information

P-Value

P=.012 for depression improvement, P=.03 for health-related quality of life improvement.

Confidence Interval

95% CI for PHQ-9: (−7.4, 3.16), for CSI: (−11.2, −0.01)

Statistical Significance

p<0.05

Digital Object Identifier (DOI)

10.1155/2011/840248

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