AIMS: Attempts to reduce high utilisation of mental health inpatient care by targeting the critical time of hospital discharge are rare. In this study, we test the effect of a needs-oriented discharge planning intervention on number and duration of psychiatric inpatient treatment episodes (primary), as well as on outpatient service use, needs, psychopathology, depression and quality of life (secondary). METHODS:Four hundred and ninety-one adults with a defined high utilisation of mental health care gave informed consent to participate in a multicentre RCT carried out at five psychiatric hospitals in Germany (Düsseldorf, Greifswald, Regensburg, Ravensburg and Günzburg). Subjects allocated to the intervention group were offered a manualised needs-led discharge planning and monitoring intervention with two intertwined sessions administered at hospital discharge and 3 months thereafter. Outcomes were assessed at four measurement points during a period of 18 months following discharge. RESULTS: Intention-to-treat analyses showed no effect of the intervention on primary or secondary outcomes. CONCLUSIONS: Process evaluation pending, the intervention cannot be recommended for implementation in routine care. Other approaches, e.g. team-based community care, might be more beneficial for people with persistent and severe mental illness.
RCT Entities:
AIMS: Attempts to reduce high utilisation of mental health inpatient care by targeting the critical time of hospital discharge are rare. In this study, we test the effect of a needs-oriented discharge planning intervention on number and duration of psychiatric inpatient treatment episodes (primary), as well as on outpatient service use, needs, psychopathology, depression and quality of life (secondary). METHODS: Four hundred and ninety-one adults with a defined high utilisation of mental health care gave informed consent to participate in a multicentre RCT carried out at five psychiatric hospitals in Germany (Düsseldorf, Greifswald, Regensburg, Ravensburg and Günzburg). Subjects allocated to the intervention group were offered a manualised needs-led discharge planning and monitoring intervention with two intertwined sessions administered at hospital discharge and 3 months thereafter. Outcomes were assessed at four measurement points during a period of 18 months following discharge. RESULTS: Intention-to-treat analyses showed no effect of the intervention on primary or secondary outcomes. CONCLUSIONS: Process evaluation pending, the intervention cannot be recommended for implementation in routine care. Other approaches, e.g. team-based community care, might be more beneficial for people with persistent and severe mental illness.
Authors: Andrea C Tricco; Jesmin Antony; Noah M Ivers; Huda M Ashoor; Paul A Khan; Erik Blondal; Marco Ghassemi; Heather MacDonald; Maggie H Chen; Lianne Kark Ezer; Sharon E Straus Journal: CMAJ Date: 2014-09-15 Impact factor: 8.262
Authors: Michael P Hengartner; Silvia Passalacqua; Gisela Heim; Andreas Andreae; Wulf Rössler; Agnes von Wyl Journal: Front Psychiatry Date: 2016-03-03 Impact factor: 4.157