Mental Disorders Clinical Trial
Official title:
Efficacy of Transitional Case Management Following Psychiatric Hospital Discharge: a Randomized Trial
Efficacy of transitional case management following psychiatric hospital discharge: a
randomized trial
Background The movement of deinstitutionalisation in Western societies has modified the role
of psychiatric hospital, which has lost its asylum function to become a place for acute
care.
Psychiatric stays are now shorter and close interactions with the outpatient care network is
therefore more critical than before. The first weeks following discharge from psychiatric
hospital represent a period of high risk for relapse, readmission or even suicide. Case
management has a proven efficacy in facilitating patients' deinstitutionalisation after very
long hospitalisations and in stabilizing high users of psychiatric care. In contrast,
studies exploring the impact of time limited case management following discharge from short
stays (transitional case management) in earlier phases of psychiatric disorders in
connection with primary care are lacking.
Working Hypotheses The investigators hypothesize that transitional case management following
hospital discharge decreases risk of readmission, improves adherence to outpatient care,
facilitates recovery and improves patients' satisfaction with treatment as compared to
routine care.
Specific Aims In this study, the investigators will compare the impact of both intervention
on number of contact and level of adherence to outpatient care. The investigators will also
compare both groups on number of readmission, risk of early aggravation of the disorders,
level of functioning and satisfaction with care.
Methods This is a randomized single-blind study comparing transitional case management after
discharge with routine post-hospitalization care for subjects living independently without
institutional psychiatric follow-up. Demographic and clinical data will be gathered during
hospitalization, and 1, 3, 6 and 12 months after discharge. Quantitative assessment of
outcomes using validated instruments will be: contact and level of adherence to outpatient
care (primary outcomes), as well as number of hospitalization days, number of readmissions,
severity of illness and satisfaction with care (secondary outcomes).
Expected Value of the Proposed Project This study should improve psychiatric patients
follow-up in collaboration with the different levels of care in the global context of
deinstitutionalization.
n/a
Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Single Blind (Subject), Primary Purpose: Treatment
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