Drop out rates ranged from 21 to 53 Commentary No follow up plan was provided

Drop out rates ranged from 21 to 53 commentary no

This preview shows page 85 - 87 out of 150 pages.

Drop-out rates ranged from 21% to 53%. Commentary No follow-up plan was provided to 55% of the ED patients studied. Consequently, the intervention was the follow-up plan for many. Groups ranged from 45 to 18 patients. Source Canada. Allard B et al. Suicide Life Threat Behav 1992;22:303–14. Design RCT. Both groups given written instructions to make clinic appointment within one week of discharge. 150 patients with 76 experimental subjects and 74 in the comparison group; each followed for 24 months. Question Will a follow-up, outpatient treatment program, begun after ED or inpatient discharge, decrease the number of suicide attempts? Target Population ED patients with indisputable suicide attempt; 22% admitted; 30 years average age; > 40% personality disorders; ≥ 55% unemployed. Intervention Explicit discharge plan followed by one month of weekly visits and eight monthly visits thereafter; one home visit; all others office visits; reminders. Selected Outcomes No differences found. Only 21 patients in the experimental group received the complete intervention. Losses to follow-up of 15%–17%. The experimental group had the highest reattempt rate (35%). Commentary Certain groups of challenged patients may not come for office visits.
Image of page 85

Subscribe to view the full document.

Continuity of Care for Suicide Prevention and Research 86 Source England. Morgan HG et al. Br J Psychiatry 1993;163:111–12. Design RCT. Usual care. 212 patients with 101 in the experimental group and 111 in the control group; each followed for 12 months. Question Will the use of a crisis card combined with on-demand access to psychiatry residents reduce the rate of suicide threats and/or attempts? Target Population ED patients that made their first suicide attempt; all admitted; about 30 years average age; most had depressive disorder. Intervention At discharge given a “green card” (i.e., a “crisis card”) describing how to contact resident at any time; written reminder sent to home and to primary care doctor; rehospitalization was an option. Selected Outcomes Follow-up data obtained after one year showed a significant reduction (4.95% versus 13.51%, P ≤ 0.05) in the combination of actual or seriously threatened self-harm behaviors in the experimental group. Only 15 intervention patients contacted resident. Commentary This is the only randomized controlled trial found regarding the safety- planning aspects of “crisis cards.” This form of protection appears to have real merits. Source Netherlands. van der Sande R et al. Br J Psychiatry 1997;171:35–41. Design RCT. Comparison to usual care. 274 patients with 140 in the experimental group and 134 in the usual care group; each followed for 12 months. Question Will an approach using (1) inpatient crisis intervention, (2) on-demand readmission, and (3) problem-solving outpatient treatment affect rates of repeat suicide attempts? The investigators labeled this “continuity of care and problem-solving treatment.” Target Population Suicide attempters, excluding self-mutilation or chronic substance use, ages 15 and older presenting to an ED; about 85% overdosed; about half
Image of page 86
Image of page 87
  • Summer '17
  • RUFFA RESENTTES

What students are saying

  • Left Quote Icon

    As a current student on this bumpy collegiate pathway, I stumbled upon Course Hero, where I can find study resources for nearly all my courses, get online help from tutors 24/7, and even share my old projects, papers, and lecture notes with other students.

    Student Picture

    Kiran Temple University Fox School of Business ‘17, Course Hero Intern

  • Left Quote Icon

    I cannot even describe how much Course Hero helped me this summer. It’s truly become something I can always rely on and help me. In the end, I was not only able to survive summer classes, but I was able to thrive thanks to Course Hero.

    Student Picture

    Dana University of Pennsylvania ‘17, Course Hero Intern

  • Left Quote Icon

    The ability to access any university’s resources through Course Hero proved invaluable in my case. I was behind on Tulane coursework and actually used UCLA’s materials to help me move forward and get everything together on time.

    Student Picture

    Jill Tulane University ‘16, Course Hero Intern

Ask Expert Tutors You can ask 0 bonus questions You can ask 0 questions (0 expire soon) You can ask 0 questions (will expire )
Answers in as fast as 15 minutes