Results of Home Visits for Schizophrenic Patients by a Preventive Medicine Team, Community Mental Health Branch, Erawan District, Loei Province: a Randomized Controlled Trial

Abstract

Objectives: Schizophrenia is a significant public health problem that impacts patients, families, and society. The lack of continuous treatment is a crucial factor leading to relapse. This study aims to examine the outcomes of home visits for schizophrenia patients conducted by community mental health preventive medicine teams. Methods: This was a Randomized Controlled Trial involving 152 schizophrenia patients at Erawan Hospital, Loei Province, between January-July 2025. Participants were randomly assigned to either the study group (receiving 3 home visits with motivational counseling) of 76 patients, or the control group (receiving standard care) of 76 patients. Outcomes were followed for 6 months and assessed using the Brief Psychiatric Rating Scale (BPRS), 9Q Depression Assessment Scale, 8Q Suicide Assessment Scale, EQ-5D-5L, and Visual Analog Scale. Results: Complete follow-up was achieved for 145 participants (loss to follow-up rate of 4.6%). The study group showed a mean reduction in BPRS scores of 5.1 points compared to the control group (p < 0.001, Cohen's d = 1.06). EQ-5D-5L quality of life scores increased by 0.11 points (p < 0.001), and VAS scores increased by 9.7 points (p < 0.001). The relapse rate decreased from 34.2% to 19.4% (p = 0.032, NNT = 7). Appointment adherence increased from 52.1% to 72.2% (p < 0.001), and medication compliance improved from 56.2% to 80.6% (p < 0.001). Conclusion: Home visits for schizophrenia patients by multidisciplinary teams combined with motivational interviewing techniques are effective in improving psychiatric symptoms, reducing relapse rates, enhancing quality of life, and increasing treatment adherence. This represents a promising approach for community-based care of schizophrenia patients.