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Trial registered on ANZCTR
Registration number
ACTRN12620000333910
Ethics application status
Not required
Date submitted
20/02/2020
Date registered
10/03/2020
Date last updated
13/07/2021
Date data sharing statement initially provided
10/03/2020
Date results provided
13/07/2021
Type of registration
Retrospectively registered
Titles & IDs
Public title
A systematic review and meta-analysis of predictors and outcomes of compulsory community treatment for severe mental illness in Australia and New Zealand
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Scientific title
A systematic review and meta-analysis of predictors and outcomes of compulsory community treatment for severe mental illness in Australia and New Zealand
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Secondary ID [1]
300717
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PROSPERO acknowledgement of receipt [155996]
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Universal Trial Number (UTN)
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Trial acronym
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
severe mental illness
316367
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Condition category
Condition code
Mental Health
314628
314628
0
0
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Schizophrenia
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Mental Health
314629
314629
0
0
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Psychosis and personality disorders
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Public Health
314777
314777
0
0
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Health service research
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Intervention/exposure
Study type
Observational
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Patient registry
False
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Target follow-up duration
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Target follow-up type
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Description of intervention(s) / exposure
Community treatment orders for compulsory psychiatric treatment. These require
people with mental disorders to reside at a specified place, and to attend specified treatment
programs that include psychoeducation and rehabilitation. Orders can also enforce medication.
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Intervention code [1]
316923
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Not applicable
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Comparator / control treatment
People on voluntary psychiatric treatment in the community. This includes voluntarily taking psychiatric medications, attending sessions with a mental health clinician or participating in psychosocial rehabilitation
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Control group
Active
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Outcomes
Primary outcome [1]
322956
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Admission to hospital for a psychiatric condition
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Assessment method [1]
322956
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Timepoint [1]
322956
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At least 12 months and up to no more than 10 years from entry into the study.
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Primary outcome [2]
322957
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Bed-days spent in hospital for psychiatric illness
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Assessment method [2]
322957
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Timepoint [2]
322957
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At least 12 months and up to no more than 10 years from entry into the study
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Primary outcome [3]
322958
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The number of clinical encounters with mental health clinicians as an outpatient or in a community setting
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Assessment method [3]
322958
0
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Timepoint [3]
322958
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At least 12 months and up to no more than 10 years from entry into the study
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Secondary outcome [1]
380361
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Psychiatric symptoms as measured by a standardised psychiatric instrument such as the Health of the Nation Outcome Scales
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Assessment method [1]
380361
0
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Timepoint [1]
380361
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At least 12 months and up to no more than 10 years from entry into the study
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Secondary outcome [2]
380362
0
Compliance with psychiatric treatment in terms of taking psychotropic medication as directed.
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Assessment method [2]
380362
0
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Timepoint [2]
380362
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At least 12 months and up to no more than 10 years from entry into the study.
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Secondary outcome [3]
380363
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Employment as defined by full or part-time work or study
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Assessment method [3]
380363
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Timepoint [3]
380363
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At least 12 months and up to no more than 10 years from entry into the study.
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Secondary outcome [4]
380364
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Contacts with the criminal justice system as defined by any arrest, conviction or imprisonment
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Assessment method [4]
380364
0
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Timepoint [4]
380364
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At least 12 months and up to no more than 10 years from entry into the study.
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Eligibility
Key inclusion criteria
Inclusion criteria will be any randomised controlled trial or quasi experimental study conducted in Australia or New Zealand that compares people on compulsory community treatment for severe mental illness who are subject to civil commitment. with controls receiving voluntary psychiatric treatment.
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Minimum age
No limit
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Maximum age
No limit
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
We will exclude studies of compulsory treatment in the community for drug or alcohol dependence and community treatments for mentally or behaviourally disordered offenders, as well as any design that does not compare people on a community treatment order with with controls receiving voluntary psychiatric treatment.
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Study design
Purpose
Psychosocial
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Duration
Longitudinal
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Selection
Defined population
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Timing
Both
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Statistical methods / analysis
We will include the following study designs in the systematic review and meta-analysis: randomised controlled trials, cohort studies, case control and cross-sectional studies. Where data are available for two or more studies, they will be combined in a meta-analysis using programmes such as RevMan, Comprehensive Meta-analysis or Win_Pepi . We will combine data using the mean difference or standardised mean difference, as appropriate, for continuous data, and the relative risk (RR) for any dichotomous outcome, assessing for publication bias where there are at least 10 studies. Where we encounter a situation where data for the same outcome are presented in some studies as dichotomous data and in others as continuous data, we will combine them using statistical approaches as recommended in the Cochrane Reviewer’s Handbook. These techniques re-express standardized mean differences as log odds ratios allowing dichotomous and continuous data to be pooled together using inverse variance.
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Recruitment
Recruitment status
Completed
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Date of first participant enrolment
Anticipated
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Actual
9/01/2020
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Date of last participant enrolment
Anticipated
15/04/2020
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Actual
15/04/2020
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Date of last data collection
Anticipated
15/04/2020
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Actual
15/04/2020
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Sample size
Target
230000
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Accrual to date
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Final
218034
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Recruitment in Australia
Recruitment state(s)
ACT,NSW,NT,QLD,SA,TAS,WA,VIC
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Recruitment outside Australia
Country [1]
22370
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New Zealand
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State/province [1]
22370
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Funding & Sponsors
Funding source category [1]
305030
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University
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Name [1]
305030
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University of Queensland Summer Scholarship Programme
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Address [1]
305030
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Research Strategy and Support Office, Faculty of Medicine
Level 6, UQ Oral Health Centre (Bldg. 883)
288 Herston Road, Herston
The University of Queensland
Brisbane Qld 4072 Australia
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Country [1]
305030
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Australia
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Primary sponsor type
Individual
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Name
Prof Steve Kisely
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Address
PA-Southside Clinical Unit l School of Clinical Medicine
Faculty of Medicine l The University of Queensland
Level 4, Building 1, Princess Alexandra Hospital, Ipswich Road, Woolloongabba, QLD 4102
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Country
Australia
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Secondary sponsor category [1]
305390
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None
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Name [1]
305390
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Address [1]
305390
0
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Country [1]
305390
0
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Ethics approval
Ethics application status
Not required
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Ethics committee name [1]
305426
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Ethics committee address [1]
305426
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Ethics committee country [1]
305426
0
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Date submitted for ethics approval [1]
305426
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Approval date [1]
305426
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Ethics approval number [1]
305426
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Summary
Brief summary
There is conflicting and equivocal evidence for the efficacy of compulsory community treatment (CCT) within Australia and overseas. In addition, although people from Indigenous or culturally and linguistically diverse backgrounds are over-represented in terms of incarceration and compulsory admissions to hospital, little is known about whether this also applies to compulsory community treatment. A previous review of compulsory community treatment worldwide did include some studies from Australia but had several limitations. Firstly it did not include several more recent studies and secondly, it only presented analyses of unadjusted data. In non-randomised studies such as cohort, case control and cross-sectional studies it is important to adjust for potential confounders to adjust for the possibility that people on compulsory community treatment may differ in important ways from voluntary controls. In addition, the review only considered admissions, bed-dsay and community contacts and did not consider other outcomes such as clinical features. Finally, it did not consider predictors of compulsory community treatment placement. This systematic review and meta-analysis therefore aims to assess predictors of CCT placement and whether people from Indigenous or culturally and linguistically diverse backgrounds are more likely to be on compulsory community treatment in Australia and New Zealand, as well as assess the subsequent effect on a range of health service, clinical and psychosocial outcomes.
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Trial website
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Trial related presentations / publications
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Public notes
Ethical approval is not required for this systematic review & meta-analysis as all included intervention data has been previously published with ethical approval and is in the public domain. We estimate there will be 29 papers from 16 papers that will be eligible for inclusion
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Contacts
Principal investigator
Name
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Prof Steve Kisely
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Address
100338
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PA-Southside Clinical Unit,
School of Clinical Medicine
Faculty of Medicine,
The University of Queensland
Level 4, Building 1, Princess Alexandra Hospital,
Ipswich Road, Woolloongabba, QLD 4102
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Country
100338
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Australia
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Phone
100338
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+61731769568
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Fax
100338
0
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Email
100338
0
[email protected]
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Contact person for public queries
Name
100339
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Steve Kisely
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Address
100339
0
PA-Southside Clinical Unit,
School of Clinical Medicine
Faculty of Medicine,
The University of Queensland
Level 4, Building 1, Princess Alexandra Hospital,
Ipswich Road, Woolloongabba, QLD 4102
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Country
100339
0
Australia
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Phone
100339
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+61731769568
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Fax
100339
0
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Email
100339
0
[email protected]
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Contact person for scientific queries
Name
100340
0
Steve Kisely
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Address
100340
0
PA-Southside Clinical Unit,
School of Clinical Medicine
Faculty of Medicine,
The University of Queensland
Level 4, Building 1, Princess Alexandra Hospital,
Ipswich Road, Woolloongabba, QLD 4102
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Country
100340
0
Australia
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Phone
100340
0
+61731769568
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Fax
100340
0
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Email
100340
0
[email protected]
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Data sharing statement
Will individual participant data (IPD) for this trial be available (including data dictionaries)?
No
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No/undecided IPD sharing reason/comment
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What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
Source
Title
Year of Publication
DOI
Embase
A systematic review and meta-analysis of predictors and outcomes of community treatment orders in Australia and New Zealand.
2021
https://dx.doi.org/10.1177/0004867420954286
N.B. These documents automatically identified may not have been verified by the study sponsor.
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