Effectiveness of a Case Management Algorithm: ALGOS After a Suicide Attempt

NCT01123174 | Completed

• 3 other identifiers: 2009_25PHRC 2009/19022009-A00893-54
• Study Type: interventional
• Target: 1,040
• Locations: 1 country
• Sites: 23

Brief Summary

The suicidal behaviors are phenomena eminently multifactorial. It is thus always difficult to define univocal strategies of prevention of suicide repetition, during the emergency stay, i.e. almost in general population. One find 23 clinical trials in this topic in the past 25 years, and 18 are negative. The majority of the positive trials have the concern of being dissociated from an assumption of responsibility of care strictly speaking, to adopt a position "méta", nearer to the concept of "case management": how to remain in contact with the suicide attempter, without forcing it in this every day life, replacing a possible proposing, but assumption of responsibility resources reliable and quickly accessible in the event of at risk situation? Each one of these studies tests devices which seem more appropriate to such or such characteristic of this population, by retaining only simple criteria like the sex, the number of former suicide attempts, the proposal or not for an assumption of responsibility of care, the observance or not with the plan of care. Thus, it would seem interesting to combine these approaches in an algorithm entitled "ALGOS". Main aim: To test the effectiveness of this algorithm of case management, named "ALGOS", in reducing the number of death by suicide, in terms of reduction of suicide re-attempts and the number of loss of contact patients in the ALGOS group during 6 months period, compared to a control group of suicide attempters treated as usual (i.e. primarily transmitted to the attending physician). Secondary objectives: To evaluate, according to the method validated by Beecham in 1992, direct medico-economic impact in the year which follows the introduction of algorithm ALGOS. Reduction of the other suicidal behaviors in 6 months (reduction in the full number of suicidal repetitions in each group, evolution of the score of suicidal ideation, etc…). To evaluate the effect of the algorithm, at the 13th month. To study the possible differences within the time in terms of suicidal repetitions in the 2 groups. To propose different profiles of answers according to psychopathology, the number of suicide attempts, suicidal character, the sex,… Methodology: Comparative simple blind prospective multicentric controlled study

Conditions

Suicide, Attempted

Keywords

Suicide; case management algorithm; suicidal behaviors; prevention of suicide

Outcome Measures

Primary Outcomes (1)

• Number of suicide re-attempters

  the number of suicide re-attempters 6 months following the attempt index

  six months

Secondary Outcomes (7)

• Number of deaths per suicide

  six months and 13 months

• Number of lost to follow up

  six months and 13 months

• Number of suicide re-attempters

  13 months

• Number of suicide re-attempts

  six months and 13 months

• Suicidal ideation intensity

  six months and 13 months

Study Arms (2)

ALGOS group

EXPERIMENTAL

Algorithm of case management over the 6 months following the suicidal gesture (systematic telephone contact, postcards and crisis card)

Behavioral: ALGOS algorithm of case management

Control group

NO INTERVENTION

Treatment as usual (referral back to the general practitioner)

Interventions

ALGOS algorithm of case management BEHAVIORAL

If the subject survives one 1st SA (first attempter): he leaves the center where he was included with a "chart resource" (crisis card) which contains addresses of the Web sites of associations of prevention of the suicide, as well as an accessible phone number 24/24h. If the subject is not a first attempter : he will be recontacted on the telephone between the 10th and the 21st day following the SA. If the subject is not contacted or little observing in the plan of care, it will receive a series of postcards then regularly, with 4 recoveries: to 2, 3, 4 and 5 months after the attempt.

Also known as: ALGOS Group

ALGOS group

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Surviving to a suicide attempt (SA) directly leaving the Emergency unit or have been hospitalized less than 7 days

You may not qualify if:

• recidivists who made 4 SA and more in the 3 past years

Sponsors & Collaborators

• University Hospital, Lille: lead

Study Sites (23)

University Hospital, Angers

Angers, France

Location

General Hospital, Boulogne sur Mer

Boulogne-sur-Mer, France

Location

University Hospital, Brest

Brest, France

Location

University Hospital, Caen

Caen, France

Location

University Hospital, Clermont Ferrand

Clermont-Ferrand, France

Location

Henri Mondor Hospital, Creteil

Créteil, France

Location

General Hospital, Douai

Douai, France

Location

General Hospital, Dunkerque

Dunkirk, France

Location

Health Centre Henin Beaumont

Hénin-Beaumont, France

Location

University Hospital, Lille

Lille, 59037, France

Location

University Hospital, Marseille

Marseille, France

Location

General Hospital, Montauban

Montauban, France

Location

University Hospital, Montpellier

Montpellier, France

Location

University Hospital, Nancy

Nancy, France

Location

University Hospital, Nantes

Nantes, France

Location

University Hospital, Nice

Nice, France

Location

Georges Pompidou European Hospital, Paris

Paris, France

Location

General Hospital, Quimper

Quimper, France

Location

University Hospital, Rennes

Rennes, France

Location

General Hospital, Roubaix

Roubaix, France

Location

University Hospital, Toulouse

Toulouse, France

Location

General Hospital, Tourcoing

Tourcoing, France

Location

General Hospital, Vannes

Vannes, France

Location

Related Publications (7)

• Vaiva G, Vaiva G, Ducrocq F, Meyer P, Mathieu D, Philippe A, Libersa C, Goudemand M. Effect of telephone contact on further suicide attempts in patients discharged from an emergency department: randomised controlled study. BMJ. 2006 May 27;332(7552):1241-5. doi: 10.1136/bmj.332.7552.1241.

  PMID: 16735333 BACKGROUND

• Carter GL, Clover K, Whyte IM, Dawson AH, D'Este C. Postcards from the EDge project: randomised controlled trial of an intervention using postcards to reduce repetition of hospital treated deliberate self poisoning. BMJ. 2005 Oct 8;331(7520):805. doi: 10.1136/bmj.38579.455266.E0. Epub 2005 Sep 23.

  PMID: 16183654 BACKGROUND

• Evans J, Evans M, Morgan HG, Hayward A, Gunnell D. Crisis card following self-harm: 12-month follow-up of a randomised controlled trial. Br J Psychiatry. 2005 Aug;187:186-7. doi: 10.1192/bjp.187.2.186.

  PMID: 16055834 BACKGROUND

• Vaiva G, Walter M, Al Arab AS, Courtet P, Bellivier F, Demarty AL, Duhem S, Ducrocq F, Goldstein P, Libersa C. ALGOS: the development of a randomized controlled trial testing a case management algorithm designed to reduce suicide risk among suicide attempters. BMC Psychiatry. 2011 Jan 2;11:1. doi: 10.1186/1471-244X-11-1.

  PMID: 21194496 BACKGROUND

• Demesmaeker A, Chazard E, Vaiva G, Amad A. Risk Factors for Reattempt and Suicide Within 6 Months After an Attempt in the French ALGOS Cohort: A Survival Tree Analysis. J Clin Psychiatry. 2021 Feb 18;82(1):20m13589. doi: 10.4088/JCP.20m13589.

  PMID: 33999539 RESULT

• Witt KG, Hetrick SE, Rajaram G, Hazell P, Taylor Salisbury TL, Townsend E, Hawton K. Psychosocial interventions for self-harm in adults. Cochrane Database Syst Rev. 2021 Apr 22;4(4):CD013668. doi: 10.1002/14651858.CD013668.pub2.

  PMID: 33884617 DERIVED

• Vaiva G, Berrouiguet S, Walter M, Courtet P, Ducrocq F, Jardon V, Larsen ME, Cailhol L, Godesense C, Couturier C, Mathur A, Lagree V, Pichene C, Travers D, Lemogne C, Henry JM, Jover F, Chastang F, Prudhomme O, Lestavel P, Gignac CT, Duhem S, Demarty AL, Mesmeur C, Bellivier F, Labreuche J, Duhamel A, Goldstein P. Combining Postcards, Crisis Cards, and Telephone Contact Into a Decision-Making Algorithm to Reduce Suicide Reattempt: A Randomized Clinical Trial of a Personalized Brief Contact Intervention. J Clin Psychiatry. 2018 Sep 25;79(6):17m11631. doi: 10.4088/JCP.17m11631.

  PMID: 30256552 DERIVED

MeSH Terms

Conditions

Suicide, Attempted; Suicide

Condition Hierarchy (Ancestors)

Self-Injurious Behavior; Behavioral Symptoms; Behavior

Study Officials

• Guillauma VAIVA

  University Hospital, Lille

  PRINCIPAL INVESTIGATOR

• Michel WALTER

  University Hospital, Brest

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: PARTICIPANT
• Purpose: SUPPORTIVE CARE
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: March 18, 2010
• First Posted: May 14, 2010
• Study Start: February 1, 2010
• Primary Completion: July 1, 2014
• Study Completion: July 1, 2014
• Last Updated: May 14, 2026

Record last verified: 2015-06

Locations

FR (23)