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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

Hassiotis, Angela; Kouroupa, Athanasia; Hamza, Leila; Marston, Louise; Romeo, Renee; Yaziji, Nahel; Hall, Ian; ... Lloyd-Evans, Brynmor; + view all (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) , Article e116. 10.1192/bjo.2023.74. Green open access

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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.pdf - Published Version

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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.

Type: Article
Title: 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
Location: England
Open access status: An open access version is available from UCL Discovery
DOI: 10.1192/bjo.2023.74
Publisher version: https://doi.org/doi:10.1192/bjo.2023.74
Language: English
Additional information: Copyright © Copyright © The Author(s), 2023. Published by Cambridge University Press on behalf of the Royal College of Psychiatrists. This is an open access article distributed under the terms of the Creative Commons CC BY license, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. https://creativecommons.org/licenses/by/4.0/
Keywords: Intellectual disability; developmental disorders; cost-effectiveness; outcome studies; intensive support.
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > Division of Psychiatry
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Epidemiology and Health
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Epidemiology and Health > Primary Care and Population Health
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > Division of Psychiatry > Epidemiology and Applied Clinical Research
URI: https://discovery-pp.ucl.ac.uk/id/eprint/10172602
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