The Western Norway Mental Health Interface Study on Referral Letters

Mental Disorders Clinical Trial

Official title:

Interface Between Primary Care and Specialist Mental Health Care - the Referral Letters

Clinical Trial Details — Status: Withdrawn

Administrative data

• NCT number: NCT01374035
• Other study ID #: NSD-24340
• Status: Withdrawn
• Phase: N/A
• Start date: August 1, 2010
• Est. completion date: December 13, 2019

Study information

• Verified date: February 2020
• Source: Helse Fonna
• Contact: n/a
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial Summary

The main object to this trial is to study the function of referral letters as a mean to coordinate the care process for adult people when referred from Primary Care to Specialised Mental Health Care. The study will explore if and to what degree the quality of these referral letters can be improved, and the potential improvement's impact on defined patient-, professional and organisational related outcomes. According to Medical Research Council guidelines for evaluating complex interventions, a stepwise design with the use of both qualitative and quantitative methods will be used to conduct a controlled intervention study.

Description:

The study is based on a stepwise progression including four steps. Within step one group interview with four mixed groups of health professionals (both Primary and Specialised Care), patient representatives and managers will be conducted. The groups will give input on firstly, what information they think is important to include in the referral letters, and secondly, what impact they think improved referral letters can have for the organisation and care within Specialised Mental Health Care. Within step two a validated check-list to assess the quality of referral letters will be developed. Within step three outcome measures will be developed and tested. Both step two and three will make use of the results from step one in addition to existing literature and testing. Step four is the intervention study where measures from the former steps will be used.

Recruitment information / eligibility

• Status: Withdrawn
• Enrollment: 0
• Est. completion date: December 13, 2019
• Est. primary completion date: June 22, 2016
• Accepts healthy volunteers: No
• Gender: All
• Age group: 18 Years and older

Eligibility

Inclusion Criteria:

• Referral letters send from a GP to Public Specialised Mental Health Care

• Referrals for elective assessment or treatment

Exclusion Criteria:

• Referral letters send from other health personnel

• Referrals for acute care (within 24 hours)

Related Conditions & MeSH terms

• Mental Disorders

Intervention

Other:
• Quality improvement intervention
A complex intervention will be implemented within the group of GPs in the intervention group. It includes participation in defining criteria for good referral letters, information about the correlation between information in the referral letters and outcome, introduction to the guideline, and consecutive feedback on own preformance regarding content of referral letter and outcome for the patient.

Locations

Country	Name	City	State
Norway	Helse Fonna Local Health Authorities	Haugesund

Sponsors (3)

Lead Sponsor	Collaborator
Helse Fonna	KU Leuven, University of Bergen

Country where clinical trial is conducted

Norway, 

References & Publications (4)

Hartveit M, Aslaksen A, Vanhaecht K, Thorsen O, Hove O, Haug K et al. Development and testing of an instrument in Western Norway to measure the quality of referral information from primary care to specialised mental health care. International Journal of Care Coordination18:2-3, 2015

Hartveit M, Biringer E, Vanhaeht K, Haug K, Aslaksen A. The Western Norway mental health interface study: a controlled intervention trial on referral letters between primary care and specialist mental health care. BMC Psychiatry. 2011 Nov 14;11:177. doi: 10.1186/1471-244X-11-177. — View Citation

Hartveit M, Thorsen O, Biringer E, Vanhaecht K, Carlsen B, Aslaksen A. Recommended content of referral letters from general practitioners to specialised mental health care: a qualitative multi-perspective study. BMC Health Serv Res. 2013 Aug 19;13:329. do — View Citation

Hartveit M, Vanhaecht K, Thorsen O, Biringer E, Haug K, Aslaksen A. Quality indicators for the referral process from primary to specialised mental health care: an explorative study in accordance with the RAND appropriateness method. BMC Health Serv Res. 2017 Jan 3;17(1):4. doi: 10.1186/s12913-016-1941-1. Review. — View Citation

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Length of stay	From date of admission or onset of out-patient treatment until date of discharge (documented in Electronic Patient Record as end of treatment periode), assessed up to six months from admission.	Day of discharge assessed up to six months
Secondary	Response time for referral letters in Specialised Mental Health Care	Unit of measure: Number of days from receiving a referral letter to the response letter is sent to the patient and the General Practitioner. The response time for all letters recieved in a six month periode before the intervention to improve the quality of referral letters will be compared with the response time after the intervention.	Referral letters will be followed for the duration of the assessment and prioritation process until response letter is sent, an expected avarage of 10 days.