Reducing Early Readmission to an Acute Psychiatric Unit

NCT06604780 | Recruiting

• 1 other identifier: PPREINGRESOTEMP
• Study Type: interventional
• Target: 836
• Locations: 1 country
• Sites: 1

Brief Summary

Early readmission to psychiatric units poses a significant challenge for both patients with mental health issues and healthcare institutions. It hampers patient progress and prognosis, and the professional approach taken during discharge can greatly influence the recovery process. This paper proposes a multicomponent discharge transition intervention to mitigate the risk of early readmission to a Mental Health Hospitalization Unit (MHHU). The intervention entails developing a measurement scale to assess patients' risk of early readmission, allowing for stratification into high, medium, and low-risk categories. Tailored intervention strategies will focus on ensuring adherence and continuity of care post-discharge, with a more comprehensive approach for high-risk patients. Additionally, a post-discharge psychotherapeutic group will be incorporated for high-risk cases to support recovery. The efficacy of the program will be analyzed by comparing the overall early readmission risk at the Regional Hospital of Malaga's MHHU with the previous year, using admission episodes from two other hospitals in the province as a control group where the intervention program is not implemented. The success of the post-discharge group psychotherapeutic intervention will be evaluated through pre-post assessments of recovery measures, functionality, subjective well-being, social support, and treatment satisfaction. This proposal aims to address the issue of early readmission to psychiatric units by enhancing predictability and understanding of intervention strategies to reduce readmission rates.

Conditions

Readmission; Mental Health Disorder; Hospitalizations Psychiatric

Keywords

early readmission; discharge interventions; psychyatric unit; continuity of care; psychotherapy group; recovery

Outcome Measures

Primary Outcomes (1)

• Early readmission rate

  Changes in the percentage of early readmissions over the total number of recorded admission episodes, considering early readmission as any admission episode that occurs within 30 days after hospital discharge.

  Data will be collected over the 12 months following the implementation of the intervention program.

Secondary Outcomes (5)

• Recovery

  Five months between pre and post evaluation

• Functionality

  Five months between pre and post evaluation

• Subjective well-being

  Five months between pre and post evaluation

• Satisfaction with treatment

  Five months between pre and post evaluation

• Perceived social support

  Five months between pre and post evaluation

Study Arms (3)

Intervention group

EXPERIMENTAL

The intervention program is based on the Discharge Transition Model for the prevention of hospital readmission in Mental Health. This is a multicomponent program that initially involves the development of a scale to assess the risk of readmission for each patient, followed by its systematic application. This allows for stratification of patients according to their risk of early readmission and adaptation of the intervention to the needs of each risk level. The intervention includes elements aimed at promoting continuity of care after discharge, transitioning back to the community setting, as well as elements aimed at enhancing personal and emotional resources through psychotherapeutic approaches.

Behavioral: Transitional discharge program

Control group I

NO INTERVENTION

To assess the effectiveness of the Multicomponent Discharge Transition Program, users from Málaga East Axarquía Hospital and North Málaga Health Management Area will be employed as the control group. Participants in the control group will continue with their usual treatment.

Control group II

NO INTERVENTION

Additionally, users from the Mental Health Management Unit of Regional Hospital of Málaga who were admitted the previous year and thus did not participate in the intervention program will also be used as a control group.

Interventions

Transitional discharge program BEHAVIORAL

For patients classified in the low-risk group, general measures would be applied. For patients in the medium-risk group, reinforced measures would be implemented. Lastly, for patients considered to be in the high-risk group, intensive case management measures would be applied, and if they meet the inclusion criteria, they would be included in the Post-Discharge Group Psychotherapeutic Intervention. 1. General measures 2. Reinforcement measures 3. Intensive measures * Intensive case management measures * Post-Discharge Psychotherapeutic Recovery Support Program: For application to patients at high risk of early readmission who meet the inclusion criteria. It consists of a multicomponent group psychotherapeutic intervention from a rehabilitative and recovery-oriented perspective. This intervention will be structured into 20 sessions, each lasting 90 minutes, held weekly in an open format.

Intervention group

Eligibility Criteria

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

You may qualify if:

• All hospital admission episodes at MHHU during the 12 months following the implementation of the Discharge Transition Intervention Program will be considered.
• The experimental group, to which the Discharge Transition Intervention Program will be applied, will consist of users whose Community Mental Health Units (CMHU) are affiliated with the Regional Hospital of Málaga.

You may not qualify if:

• Users belonging to other hospitals in the province will be excluded from the intervention program and will form part of the control group.
• Post-Discharge Group Psychotherapy Support Recovery has its own eligibility criteria:
• Be of legal age.
• Speak spanish fluently.
• Have had recent admission to the MHHU of the Regional Hospital of Málaga and a score considered as "High Risk" on the Early Rehospitalization Risk Scale or have experienced an early rehospitalization.
• Belong to the Clinical Management Unit of Mental Health of the RUH of Málaga.
• Have sufficient cognitive capacity to understand the rules and contents of the group intervention.
• Individuals whose primary diagnosis is a Mental and Behavioral Disorder due to psychoactive substance use.
• Moderate or severe intellectual disability.
• Clinical Management Unit belonging to a hospital other than the RUH of Málaga.
• Lack of commitment to attending sessions or complying with group rules.

Sponsors & Collaborators

• Fundación Pública Andaluza para la Investigación de Málaga en Biomedicina y Salud: lead

Study Sites (1)

Vera Carbonell Aranda

Málaga, 29009, Spain

RECRUITING

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  BACKGROUND

MeSH Terms

Conditions

Mental Disorders

Study Officials

• Vera Carbonell Aranda, Bachelor

  Fundación Pública Andaluza para la Investigación de Málaga en Biomedicina y Salud

  PRINCIPAL INVESTIGATOR

Central Study Contacts

Vera Carbonell Aranda, Bachelor

CONTACT

695992369; vera.caar@hotmail.com

José Guzmán Parra, Doctor

CONTACT

951290307; jose.guzman.parra.sspa@juntadeandalucia.es

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: NON RANDOMIZED
• Masking: DOUBLE
• Who Masked: PARTICIPANT, OUTCOMES ASSESSOR
• Purpose: HEALTH SERVICES RESEARCH
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: August 14, 2024
• First Posted: September 20, 2024
• Study Start: January 1, 2023
• Primary Completion: March 30, 2024
• Study Completion: March 30, 2025
• Last Updated: September 20, 2024

Record last verified: 2024-04

Data Sharing

• IPD Sharing: Will not share

Locations

ES (1)