Effectiveness of a telephone management programme for patients discharged from an emergency department after a suicide attempt: Controlled study in a Spanish population

Objective: To determine the effectiveness over one year of a specific telephone management programme on patients discharged from an emergency department (ED) after a suicide attempt. We hypothesized that the programme will reduce the percentage of patients re-attempting suicide and delay the time be...

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Autores: Cebrià, AI, Parra, I, Pàmias, M, Escayola, A, García-Parés, G, Puntí, J, Laredo, A, Vallès, V, Cavero, M, Oliva, JC, Hegerl, U, Pérez-Solà, V, Palao, DJ
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2013
País:España
Institución:Institut d'Investigació i Innovació Parc Taulí (I3PT)
Repositorio:r-I3PT. Repositorio Institucional Producción Científica del Institut d'Investigació i Innovació Parc Taulí
OAI Identifier:oai:i3pt.fundanetsuite.com:p7019
Acceso en línea:https://i3pt.portalinvestigacion.com/publicaciones/7019
Access Level:acceso abierto
Palabra clave:Experimental study
Population-based
Suicide attempt
Telephone follow-up
Suicide prevention
Discharge from emergency department
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dc.title.none.fl_str_mv Effectiveness of a telephone management programme for patients discharged from an emergency department after a suicide attempt: Controlled study in a Spanish population
title Effectiveness of a telephone management programme for patients discharged from an emergency department after a suicide attempt: Controlled study in a Spanish population
spellingShingle Effectiveness of a telephone management programme for patients discharged from an emergency department after a suicide attempt: Controlled study in a Spanish population
Cebrià, AI
Experimental study
Population-based
Suicide attempt
Telephone follow-up
Suicide prevention
Discharge from emergency department
title_short Effectiveness of a telephone management programme for patients discharged from an emergency department after a suicide attempt: Controlled study in a Spanish population
title_full Effectiveness of a telephone management programme for patients discharged from an emergency department after a suicide attempt: Controlled study in a Spanish population
title_fullStr Effectiveness of a telephone management programme for patients discharged from an emergency department after a suicide attempt: Controlled study in a Spanish population
title_full_unstemmed Effectiveness of a telephone management programme for patients discharged from an emergency department after a suicide attempt: Controlled study in a Spanish population
title_sort Effectiveness of a telephone management programme for patients discharged from an emergency department after a suicide attempt: Controlled study in a Spanish population
dc.creator.none.fl_str_mv Cebrià, AI
Parra, I
Pàmias, M
Escayola, A
García-Parés, G
Puntí, J
Laredo, A
Vallès, V
Cavero, M
Oliva, JC
Hegerl, U
Pérez-Solà, V
Palao, DJ
author Cebrià, AI
author_facet Cebrià, AI
Parra, I
Pàmias, M
Escayola, A
García-Parés, G
Puntí, J
Laredo, A
Vallès, V
Cavero, M
Oliva, JC
Hegerl, U
Pérez-Solà, V
Palao, DJ
author_role author
author2 Parra, I
Pàmias, M
Escayola, A
García-Parés, G
Puntí, J
Laredo, A
Vallès, V
Cavero, M
Oliva, JC
Hegerl, U
Pérez-Solà, V
Palao, DJ
author2_role author
author
author
author
author
author
author
author
author
author
author
author
dc.subject.none.fl_str_mv Experimental study
Population-based
Suicide attempt
Telephone follow-up
Suicide prevention
Discharge from emergency department
topic Experimental study
Population-based
Suicide attempt
Telephone follow-up
Suicide prevention
Discharge from emergency department
description Objective: To determine the effectiveness over one year of a specific telephone management programme on patients discharged from an emergency department (ED) after a suicide attempt. We hypothesized that the programme will reduce the percentage of patients re-attempting suicide and delay the time between attempts. Design: A multicentre, case-control, population-based study. The effect of the 1-year intervention on the main outcome measures was evaluated with respect to a 1-year baseline period and a control group. Setting: Two hospitals with distinct catchment areas in Catalonia (Spain). Participants: A total of 991 patients discharged from the ED of either hospital after a suicide attempt during the baseline year and the intervention year. Intervention: The intervention was carried out on patients discharged from the ED for attempted suicide (Sabadell). It consisted of a systematic, one-year telephone follow-up programme: after 1 week, thereafter at 1, 3, 6,9 and 12-month intervals, to assess the risk of suicide and increasing adherence to treatment. The population in the control group (Terrassa) received treatment as usual after discharge, without additional telephone management. Main outcome measures: Time elapsed between initial suicide attempt and subsequent one, and changes in the annual rate of patients who reattempted suicide in the year of the intervention and the preceding one. Results: The telephone management programme delayed suicide reattempts in the intervention group compared to the baseline year (mean time in days to first reattempt, year 2008=346.47, sd=4.65; mean time in days to first reattempt, year 2007=316.46, sd = 7.18; P<0.0005; chi(2)=12.1, df=1) and compared to the control population during the same period (mean time in days to first reattempt, treatment period=346.47, sd=4.65; mean time in days to first reattempt, pre-treatment period=300.36, sd=10.67; P<0.0005; chi(2)=16.8, df=1). The intervention reduced the rate of patients who reattempted suicide in the experimental population compared to the previous year (Intervention 6% (16/296) v Baseline 14% (39/285) difference 8%, 95% confidence interval 2% to 12%) and to the control population (Intervention 6% (16/296) v Control 14% (31/218) difference 8%, -13% to -2%) Limitations: One of the main obstacles was the difficulty to contact all patients within the established deadlines. Another limitation of our study was that patients under the age of 18 underwent an intensive intervention in the day hospital, although their number was very small (13/319 in 2008) and did not significantly influence the results. But the main limitation of our study was that it was performed within the EAAD project. This project includes a comprehensive multilevel intervention practically in the same experimental area and aimed at an early diagnosis and treatment of depression, which is the main psychiatric disorder associated with suicide. Moreover, longer-term studies should be encouraged to determine whether such interventions really reduce suicide Conclusion: A telephone management programme for patients discharged from an ED after a suicide attempted would be a useful strategy in delaying further suicide attempts and in reducing the rate of reattempts, which is known as the highest risk factor for suicide completion. (C) 2012 Elsevier B.V. All rights reserved.
publishDate 2013
dc.date.none.fl_str_mv 2013
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info:eu-repo/semantics/publishedVersion
format article
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dc.identifier.none.fl_str_mv https://i3pt.portalinvestigacion.com/publicaciones/7019
url https://i3pt.portalinvestigacion.com/publicaciones/7019
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.rights.none.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.publisher.none.fl_str_mv ELSEVIER
publisher.none.fl_str_mv ELSEVIER
dc.source.none.fl_str_mv JOURNAL OF AFFECTIVE DISORDERS
ISSN: 01650327
ISSNe: 15732517
reponame:r-I3PT. Repositorio Institucional Producción Científica del Institut d'Investigació i Innovació Parc Taulí
instname:Institut d'Investigació i Innovació Parc Taulí (I3PT)
instname_str Institut d'Investigació i Innovació Parc Taulí (I3PT)
reponame_str r-I3PT. Repositorio Institucional Producción Científica del Institut d'Investigació i Innovació Parc Taulí
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spelling Effectiveness of a telephone management programme for patients discharged from an emergency department after a suicide attempt: Controlled study in a Spanish populationCebrià, AIParra, IPàmias, MEscayola, AGarcía-Parés, GPuntí, JLaredo, AVallès, VCavero, MOliva, JCHegerl, UPérez-Solà, VPalao, DJExperimental studyPopulation-basedSuicide attemptTelephone follow-upSuicide preventionDischarge from emergency departmentObjective: To determine the effectiveness over one year of a specific telephone management programme on patients discharged from an emergency department (ED) after a suicide attempt. We hypothesized that the programme will reduce the percentage of patients re-attempting suicide and delay the time between attempts. Design: A multicentre, case-control, population-based study. The effect of the 1-year intervention on the main outcome measures was evaluated with respect to a 1-year baseline period and a control group. Setting: Two hospitals with distinct catchment areas in Catalonia (Spain). Participants: A total of 991 patients discharged from the ED of either hospital after a suicide attempt during the baseline year and the intervention year. Intervention: The intervention was carried out on patients discharged from the ED for attempted suicide (Sabadell). It consisted of a systematic, one-year telephone follow-up programme: after 1 week, thereafter at 1, 3, 6,9 and 12-month intervals, to assess the risk of suicide and increasing adherence to treatment. The population in the control group (Terrassa) received treatment as usual after discharge, without additional telephone management. Main outcome measures: Time elapsed between initial suicide attempt and subsequent one, and changes in the annual rate of patients who reattempted suicide in the year of the intervention and the preceding one. Results: The telephone management programme delayed suicide reattempts in the intervention group compared to the baseline year (mean time in days to first reattempt, year 2008=346.47, sd=4.65; mean time in days to first reattempt, year 2007=316.46, sd = 7.18; P<0.0005; chi(2)=12.1, df=1) and compared to the control population during the same period (mean time in days to first reattempt, treatment period=346.47, sd=4.65; mean time in days to first reattempt, pre-treatment period=300.36, sd=10.67; P<0.0005; chi(2)=16.8, df=1). The intervention reduced the rate of patients who reattempted suicide in the experimental population compared to the previous year (Intervention 6% (16/296) v Baseline 14% (39/285) difference 8%, 95% confidence interval 2% to 12%) and to the control population (Intervention 6% (16/296) v Control 14% (31/218) difference 8%, -13% to -2%) Limitations: One of the main obstacles was the difficulty to contact all patients within the established deadlines. Another limitation of our study was that patients under the age of 18 underwent an intensive intervention in the day hospital, although their number was very small (13/319 in 2008) and did not significantly influence the results. But the main limitation of our study was that it was performed within the EAAD project. This project includes a comprehensive multilevel intervention practically in the same experimental area and aimed at an early diagnosis and treatment of depression, which is the main psychiatric disorder associated with suicide. Moreover, longer-term studies should be encouraged to determine whether such interventions really reduce suicide Conclusion: A telephone management programme for patients discharged from an ED after a suicide attempted would be a useful strategy in delaying further suicide attempts and in reducing the rate of reattempts, which is known as the highest risk factor for suicide completion. (C) 2012 Elsevier B.V. All rights reserved.ELSEVIER2013info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionhttps://i3pt.portalinvestigacion.com/publicaciones/7019JOURNAL OF AFFECTIVE DISORDERSISSN: 01650327ISSNe: 15732517reponame:r-I3PT. Repositorio Institucional Producción Científica del Institut d'Investigació i Innovació Parc Taulíinstname:Institut d'Investigació i Innovació Parc Taulí (I3PT)Inglésinfo:eu-repo/semantics/openAccessoai:i3pt.fundanetsuite.com:p70192026-06-21T15:30:37Z
score 15,812429

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