Clinical and cost evaluation of intensive support team (IST) models for adults with intellectual disabilities who display challenging behaviour: a comparative cohort study protocol

Angela Hassiotis, Athanasia Kouroupa, Rebecca Jones, Nicola Morant, Ken Courtenay, Ian Hall, Vicky Crossey, Renee Romeo, Laurence Taggart, Peter Langdon, Victoria Ratti, Vincent Kirchner, Brynmor Lloyd-Evans

Research output: Contribution to journalArticlepeer-review

Abstract

Approximately 17% of adults with intellectual disabilities (ID) living in the community display behaviours that challenge. Intensive support teams (ISTs) have been recommended to provide high-quality responsive care aimed at avoiding unnecessary admissions and reducing lengthy inpatient stays in England. We have identified two models of ISTs (model 1: enhanced provision and model 2: independent provision). This study aims to investigate the clinical and cost-effectiveness of the two models of ISTs. A cohort of 226 adults with ID displaying behaviour that challenges who receive support from ISTs from each model will be recruited and assessed at baseline and 9 months later to compare the clinical and cost-effectiveness between models. The primary outcome is reduction in challenging behaviour measured by the Aberrant Behaviour Checklist-Community (ABC-C). The mean difference in change in ABC score between the two IST models will be estimated from a multilevel linear regression model. Secondary outcomes include mental health status, clinical risk, quality of life, health-related quality of life, level of functioning and service use. We will undertake a cost-effectiveness analysis taking both a health and social care and wider societal perspective. Semistructured interviews will be conducted with multiple stakeholders (ie, service users, paid/family carers, IST managers/staff) to investigate the experience of IST care as well as an online survey of referrers to capture their contact with the teams. The study was approved by the London-Bromley Research Ethics Committee (REC reference: 18/LO/0890). Informed consent will be obtained from the person with ID, or a family/nominated consultee for those lacking capacity and from his/her caregivers. The findings of the study will be disseminated to academic audiences, professionals, experts by experience and arm's-length bodies and policymakers via publications, seminars and digital platforms. ClinicalTrials.gov Registry (NCT03586375). [Abstract copyright: © Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY. Published by BMJ.]
Original languageEnglish
Article numbere043358
Pages (from-to)1-7
Number of pages7
JournalBMJ Open
Volume11
Issue number3
Early online date30 Mar 2021
DOIs
Publication statusE-pub ahead of print - 30 Mar 2021

Keywords

  • adult psychiatry
  • delirium & cognitive disorders
  • organisation of health services
  • psychiatry

Fingerprint

Dive into the research topics of 'Clinical and cost evaluation of intensive support team (IST) models for adults with intellectual disabilities who display challenging behaviour: a comparative cohort study protocol'. Together they form a unique fingerprint.

Cite this