Psychiatric Illness Clinical Trial
Official title:
Reducing Inpatient Readmission Rates for Patients Discharged From Acute Psychiatric Care in Alberta Using Peer and Text Message Support: Protocol for an Innovative Supportive Program
Verified date | April 2024 |
Source | University of Alberta |
Contact | n/a |
Is FDA regulated | No |
Health authority | |
Study type | Interventional |
Avoidable hospital readmissions are a pressing problem for our healthcare system. They lead to substantial human suffering and higher financial costs. Most discharged psychiatric inpatients in Alberta are offered follow-up appointments with Alberta Health Services (AHS) Addiction and Mental Health (AMH) community providers. Patients often wait 28-38 weeks for their first appointment, which leads many to miss their first appointments, and increases the likelihood of relapse. As a result, patients discharged into the community are readmitted to the Emergency Department (ED). To address this significant revolving door, the investigators will implement a low-cost, evidence-based system that delivers daily supportive texts to patients' mobile phones. The text messages developed by experts and service users, based on cognitive behavioral therapy principles. Our proposed program also includes peer support from previous mental health patients who have had similar challenges as participants, but are now in recovery. In this way, the investigators aim to reduce the psychological treatment and support gap for AMH patients who have been discharged from acute care and are scheduled to receive mental health and psychiatric treatment from A&MH services after a long wait. Our pilot test of these interventions provide evidence that psychiatric readmissions, and emergency department visits can be reduced by 10-25% if implemented at scale in Alberta, thus resulting in cost-savings for individuals and the province.
Status | Active, not recruiting |
Enrollment | 1132 |
Est. completion date | September 30, 2024 |
Est. primary completion date | March 31, 2024 |
Accepts healthy volunteers | No |
Gender | All |
Age group | 18 Years to 65 Years |
Eligibility | Inclusion Criteria: - Patients who are 18 or 65 years of age - Able to provide informed written consent have been diagnosed with mental health condition, and are ready for discharge. - Patients should have a mobile device capable of receiving text messages Exclusion Criteria: - Patients will be ineligible if they do not meet the above inclusion criteria, - If they have an addiction disorder but not a mental health diagnosis - Are not capable of reading text messages from a mobile device or if they know they will be out of town during the 12-month follow-up period. - Patients are also ineligible if they do not consent to take part in the study, |
Country | Name | City | State |
---|---|---|---|
Canada | Foothills Hospital | Calgary | |
Canada | Alberta Hospital | Edmonton | Alberta |
Canada | Grey Nuns Hospital | Edmonton | Alberta |
Canada | Misericordia Community Hospital | Edmonton | Alberta |
Canada | Royal Alexander Hospital | Edmonton | Alberta |
Canada | University of Alberta Hospital | Edmonton | Alberta |
Canada | Northern Lights Regional Health Centre | Fort McMurray | Alberta |
Lead Sponsor | Collaborator |
---|---|
University of Alberta | Alberta Innovates Health Solutions |
Canada,
Adu MK, Shalaby R, Eboreime E, Sapara A, Nkire N, Chawla R, Chima C, Achor M, Osiogo F, Chue P, Greenshaw AJ, Agyapong VI. Text Messaging Versus Email Messaging to Support Patients With Major Depressive Disorder: Protocol for a Randomized Hybrid Type II Effectiveness-Implementation Trial. JMIR Res Protoc. 2021 Oct 13;10(10):e29495. doi: 10.2196/29495. Erratum In: JMIR Res Protoc. 2021 Nov 8;10(11):e34515. — View Citation
Agyapong VI, Ahern S, McLoughlin DM, Farren CK. Supportive text messaging for depression and comorbid alcohol use disorder: single-blind randomised trial. J Affect Disord. 2012 Dec 10;141(2-3):168-76. doi: 10.1016/j.jad.2012.02.040. Epub 2012 Mar 29. — View Citation
Agyapong VI, Mrklas K, Juhas M, Omeje J, Ohinmaa A, Dursun SM, Greenshaw AJ. Cross-sectional survey evaluating Text4Mood: mobile health program to reduce psychological treatment gap in mental healthcare in Alberta through daily supportive text messages. BMC Psychiatry. 2016 Nov 8;16(1):378. doi: 10.1186/s12888-016-1104-2. — View Citation
Agyapong VIO, Juhas M, Ohinmaa A, Omeje J, Mrklas K, Suen VYM, Dursun SM, Greenshaw AJ. Randomized controlled pilot trial of supportive text messages for patients with depression. BMC Psychiatry. 2017 Aug 2;17(1):286. doi: 10.1186/s12888-017-1448-2. — View Citation
Shalaby RAH, Agyapong VIO. Peer Support in Mental Health: Literature Review. JMIR Ment Health. 2020 Jun 9;7(6):e15572. doi: 10.2196/15572. — View Citation
Type | Measure | Description | Time frame | Safety issue |
---|---|---|---|---|
Other | Change in the Reach of the Text4Support | We will monitor and evaluate changes in the proportion of target population who receive the supportive text messages | baseline, 24 weeks, 52 weeks | |
Other | Change in the fidelity of the intervention | We will monitor and evaluate changes in the adherence of peer support workers to the implementation guidelines/protocols | baseline, 24 weeks, 52 weeks | |
Other | Sustainability of the intervention | We will evaluate the proportion of implementation sites who continue implementing the intervention after the active phase of the project | 52 weeks | |
Other | Acceptability of the intervention | Using satisfaction surveys, we will evaluate the proportion of participants who found the intervention acceptable | 52 weeks | |
Primary | Change in 30 day readmission rate | Readmission to acute psychiatric care within 30 days of discharge | baseline, 24 weeks, 52 weeks | |
Secondary | Change in Clinical Outcomes in Routine Evaluation 10 (CORE-10) scores | The CORE-10 is a short 10 item easy-to-use assessment measure for common presentations of psychological distress, designed to be used for screening as well as over the course of treatment to track progress. The measure is a shortened version of the 34 item CORE Outcome Measure tool, both of which ask respondents to self-report symptoms over the past week. | baseline, 24 weeks, 52 weeks | |
Secondary | Change in EuroQol- 5 Dimension (EQ-5D)scores | EQ-5D is an instrument which evaluates the generic quality of life | baseline, 24 weeks, 52 weeks | |
Secondary | Change in Patient Health Questionnaire (PHQ-9) scores | The PHQ-9 is a multipurpose instrument for screening, diagnosing, monitoring and measuring the severity of depression: n The PHQ-9 incorporates the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) depression diagnostic criteria with other leading major depressive symptoms into a brief self-report tool. | baseline, 24 weeks, 52 weeks | |
Secondary | Change in Recovery Assessment Scale (RAS)scores | The RAS is a 20-item measure developed as an outcome measure for program evaluations. Based on a process model of recovery, the RAS attempts to assess aspects of recovery with a special focus on hope and self-determination. | baseline, 24 weeks, 52 weeks | |
Secondary | Change in Brief Resilience Scale scores | The Brief Resilience Scale was created to assess the perceived ability to bounce back or recover from stress. The scale was developed to assess a unitary construct of resilience, including both positively and negatively worded items. The possible score range is from 1 (low resilience) to 5 (high resilience). | baseline, 24 weeks, 52 weeks |
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