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Routine Risk Assessment and Care Evaluation (RACE) in outpatient forensic psychiatry


- candidate number2711
- NTR NumberNTR1042
- ISRCTNISRCTN wordt niet meer aangevraagd
- Date ISRCTN created
- date ISRCTN requested
- Date Registered NTR27-aug-2007
- Secondary IDsZonMw 100-003-023 
- Public TitleRoutine Risk Assessment and Care Evaluation (RACE) in outpatient forensic psychiatry
- Scientific TitleEffectiveness of routine Risk Assessment and Care Evaluation (RACE) in violence prevention in outpatient forensic psychiatry; a randomized clinical trial
- ACRONYMRACE
- hypothesisRoutine risk assessment and care evaluation reduces the frequency of violent behaviour (primary outcome) in outpatient forensic psychiatric clients, and increases the quality of life, psychiatric and social functioning, and satisfaction with care of the clients
- Healt Condition(s) or Problem(s) studiedMental health problems, Behavioural disorders
- Inclusion criteriaIncluded are clients of outpatient forensic psychiatric services.
- Exclusion criteria1. Seen less than once a month on average by their case manager;
2. Whose treatment is expected to end within three months.
- mec approval receivedyes
- multicenter trialyes
- randomisedyes
- masking/blindingSingle
- controlActive
- groupParallel
- Type[default]
- Studytypeintervention
- planned startdate 1-sep-2007
- planned closingdate1-sep-2010
- Target number of participants680
- InterventionsIn the experimental group routine risk assessment and care evaluation is carried out at every formal evaluation of the care plan, but at least once every six months. It consists of (1) an assessment of the violence risk of the client by the case manager using the START (Short-Term Assessment of Risk and Treatability), and (2) a standardized evaluation by the case manager and client of the client's needs for care and satisfaction with care (covering a.o. the view of the client, the view of the case manager or care team, and discussion of adjustments to care). In the control condition no formal method of risk assessment or care evaluation is used, and Care-As-Usual is offered.
- Primary outcomeThe proportion of clients showing ‘violent behaviour’ (including criminal behaviour, physical violence, and verbal aggression) in the six months prior to follow-up (at 18 months or end or treatment). Information on violent behaviour is gathered in two ways. First, by continuous registration of violent incidents by the case manager, as part of the medical record of clients in both research conditions. And second, by self-report in a follow-up interview. Any reports of a violent incident is judged by a panel of forensic psychiatric experts, who will be blind about the research condition of the client, as will be the interviewers.
- Secondary outcomeSecondary outcomes are ‘risk enhancing behaviour’ (e.g. breaking of agreements, stopping necessary medication, drug abuse), quality of life, psychiatric and social functioning, aggression, impulsivity, and satisfaction with care and the therapeutic relation.
- Timepoints
- Trial web siteN/A
- statusopen: patient inclusion
- CONTACT FOR PUBLIC QUERIESM.S. Nadine Troquete
- CONTACT for SCIENTIFIC QUERIESdr Rob Brink, van den
- Sponsor/Initiator University Medical Center Groningen (UMCG), Department of Psychiatry, GGZ Drenthe, Rob Giel Research Center for Mental Health Services Research
- Funding
(Source(s) of Monetary or Material Support)
ZON-MW, The Netherlands Organization for Health Research and Development, Mental Health Organization Drenthe
- Publications
- Brief summaryViolence risk assessment for forensic psychiatric patients has been dominated by the problem of violence prediction for release decisions. What has been neglected is the problem of ongoing risk monitoring and management for clients who receive (after)care in the community. This setting calls for a different approach; one that focuses on dynamic factors within the individual and situation, that determine the short term risk for violence and identify needs for risk management measures. We developed a risk assessment procedure for outpatient forensic psychiatry, that is integrated with routine care evaluation by the case manager and client. In a pilot study we tested its feasibility and predictive validity for violent behaviour. In the present RCT we test whether routine Risk Assessment and Care Evaluation (RACE) actually prevents violence.
- Main changes (audit trail)
- RECORD27-aug-2007 - 6-mrt-2008


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