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ReadmissionPPREINGRESOSNCT06604780

Reducing Early Readmission to an Acute Psychiatric Unit

A study testing Transitional discharge program in people with Readmission and Mental Health Disorder, run by Fundación Pública Andaluza para la Investigación de Málaga en Biomedicina y Salud at 1 site in Spain.

Unknown status

Status not confirmed. The sponsor has not verified this record for over two years, so it may be out of date.

Official record
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Trial 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. Read more about this study

Who is it for?
Ages 18 years and older
What is being tested?
Transitional discharge program
Could I receive a placebo?
No, everyone receives an active treatment
How many people
836 participants
Where
1 siteSpain
Study dates
1 Jan 2023to 30 Mar 2025
Phase
Interventional
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • 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.
  • 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.

Who cannot join

  • 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:
  • 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.

Trial locations and contacts

1 site in 1 country.

Vera Carbonell Aranda, Bachelor contact

695992369

vera.caar@hotmail.com

José Guzmán Parra, Doctor contact

951290307

jose.guzman.parra.sspa@juntadeandalucia.es

Spain1 site, 1 recruiting
  • Vera Carbonell Aranda

    Málaga, 29009

    Vera Carbonell Aranda, 695992369, vera.caar@hotmail.com

    José Guzmán Parra, Doctor, 951290307, jose.guzman.parra.sspa@juntadeandalucia.es

    Recruiting

Other trials in Spain

About this study

Official title: Implementation and Evaluation of a Transition to Discharge Program for the Reduction of Early Readmission in a Mental Health Inpatient Unit

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.

Read the detailed description

The aim of this study is, firstly, to create a tool for assessing the risk of early readmission that allows for stratification of admitted patients according to their risk level, based on the analysis of clinical and sociodemographic variables. The second objective is to implement an intervention program tailored to each risk level, involving coordination among all involved mental health units and a specific intensive program for patients at higher risk.

The present study is a quasi-experimental cluster clinical trial aimed at assessing the efficacy of a multicomponent discharge transition program for the reduction of early readmissions in a MHHU. The development of this study consists of two distinct parts or elements:

To carry out the main objective, a quasi-experimental design with a control group will be used, and within the intervention, an early readmission risk assessment scale will be created to categorize patients into different risk levels.

In addition, a study will be conducted to assess the predictive value and validity of the early readmission risk rating scale and to study the risk factors for early readmission.

Being tested
Transitional discharge program
Keywords
early readmission, discharge interventions, psychyatric unit, continuity of care, psychotherapy group, recovery
Medical subject headings
Mental Disorders

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Transitional discharge programBehavioural

    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.
Study groups in NCT06604780
Study groupRoleWhat they receive
Intervention groupExperimentalThe 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.
Receives: Behavioral: Transitional discharge program
Control group INo interventionTo 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 IINo interventionAdditionally, 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.

What is being measured

The primary outcome is the main question the study is designed to answer.

  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.

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

Secondary outcomes (5)
  1. Recovery

    Changes in measures of recovery, will be assessed through pre-post administration of the QPR-15-SP questionnaire.

    Measured: Five months between pre and post evaluation

  2. Functionality

    Changes in measures of functionality, will be assessed through pre-post administration of the PSP questionnaire.

    Measured: Five months between pre and post evaluation

  3. Subjective well-being

    Changes in measures of subjective well-being, will be assessed through pre-post administration of the Core-Om questionnaire.

    Measured: Five months between pre and post evaluation

  4. Satisfaction with treatment

    Changes in measures of satisfaction with treatment, will be assessed through pre-post administration of the CAT questionnaire.

    Measured: Five months between pre and post evaluation

  5. Perceived social support

    Changes in Perceived social support will be assessed through pre-post administration of the DUKE-UNK questionnaire.

    Measured: Five months between pre and post evaluation

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted20 Sep 2024
  2. Study start1 Jan 2023
  3. Primary completion30 Mar 2024
  4. Study completion30 Mar 2025 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Health services research
Allocation
Non-randomised
Intervention model
Parallel groups
Masking
Double blind
Who is masked
Participant, Outcomes assessor
Enrolment
836 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT06604780
Sponsor's protocol ID
PPREINGRESOTEMP
Acronym
PPREINGRESOS
Status last verified
Apr 2024
First submitted
14 Aug 2024
Last updated
20 Sep 2024
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Publications

  • Tyler N, Wright N, Waring J. Interventions to improve discharge from acute adult mental health inpatient care to the community: systematic review and narrative synthesis. BMC Health Serv Res. 2019 Nov 25;19(1):883. doi: 10.1186/s12913-019-4658-0.

    PubMed 31760955
  • Donisi V, Tedeschi F, Salazzari D, Amaddeo F. Pre- and post-discharge factors influencing early readmission to acute psychiatric wards: implications for quality-of-care indicators in psychiatry. Gen Hosp Psychiatry. 2016 Mar-Apr;39:53-8. doi: 10.1016/j.genhosppsych.2015.10.009. Epub 2015 Nov 1.

    PubMed 26804775
  • Wobrock T, Weinmann S, Falkai P, Gaebel W. Quality assurance in psychiatry: quality indicators and guideline implementation. Eur Arch Psychiatry Clin Neurosci. 2009 Nov;259 Suppl 2(Suppl 2):S219-26. doi: 10.1007/s00406-009-0072-7.

    PubMed 19876682
  • Vigod SN, Kurdyak PA, Seitz D, Herrmann N, Fung K, Lin E, Perlman C, Taylor VH, Rochon PA, Gruneir A. READMIT: a clinical risk index to predict 30-day readmission after discharge from acute psychiatric units. J Psychiatr Res. 2015 Feb;61:205-13. doi: 10.1016/j.jpsychires.2014.12.003. Epub 2014 Dec 13.

    PubMed 25537450
  • Vigod SN, Kurdyak PA, Dennis CL, Leszcz T, Taylor VH, Blumberger DM, Seitz DP. Transitional interventions to reduce early psychiatric readmissions in adults: systematic review. Br J Psychiatry. 2013 Mar;202(3):187-94. doi: 10.1192/bjp.bp.112.115030.

    PubMed 23457182
  • Owusu E, Oluwasina F, Nkire N, Lawal MA, Agyapong VIO. Readmission of Patients to Acute Psychiatric Hospitals: Influential Factors and Interventions to Reduce Psychiatric Readmission Rates. Healthcare (Basel). 2022 Sep 19;10(9):1808. doi: 10.3390/healthcare10091808.

    PubMed 36141418
  • Hegedus A, Kozel B, Richter D, Behrens J. Effectiveness of Transitional Interventions in Improving Patient Outcomes and Service Use After Discharge From Psychiatric Inpatient Care: A Systematic Review and Meta-Analysis. Front Psychiatry. 2020 Jan 21;10:969. doi: 10.3389/fpsyt.2019.00969. eCollection 2019.

    PubMed 32038320
  • García-Herrera Pérez-Bryan JM, Hurtado Lara MM, Quemada González C, Nogueras Morillas EV, Bordallo Aragón A, Martí García C, et al. Guía de Práctica Clínica para el Tratamiento de la Psicosis y la Esquizofrenia. Manejo en Atención Primaria y en Salud Mental. [Internet]. Plan Integral de Salud Mental. Servicio Andaluz de Salud, editor. 2019 [cited 2024 Jan 29]. Available from: https://www.sspa.juntadeandalucia.es/servicioandaluzdesalud/sites/default/files/sincfiles/wsas-media-pdf_publicacion/2020/1gpc_psicosis_completa.pdf

  • Ministerio de Ciencia e Innovación. Guía de Práctica Clínica de intervenciones psicosociales en el trastorno mental grave [Internet]. 2009 [cited 2024 Jan 29]. Available from: https://portal.guiasalud.es/wp-content/uploads/2018/12/GPC_453_TMG_ICS_compl.pdf

  • Lam M, Li L, Anderson KK, Shariff SZ, Forchuk C. Evaluation of the transitional discharge model on use of psychiatric health services: An interrupted time series analysis. J Psychiatr Ment Health Nurs. 2020 Apr;27(2):172-184. doi: 10.1111/jpm.12562. Epub 2019 Sep 29.

    PubMed 31529589
  • Chris Evans JMCFMMBKAJCGM. CORE: Clinical Outcomes in Routine Evaluation. http://dx.doi.org/101080/jmh93247255. 2009 Jan;9(3):247-55.

  • Feixas i Viaplana G, Evans C, Trujillo A, Saúl Gutiérrez LÁ, Botella L, Corbella S, et al. La versión española del CORE-OM: Clinical Outcomes in Routine Evaluation - Outcome Measure. Revista de Psicoterapia. 2012;23(89):109-35.

  • Bellon Saameno JA, Delgado Sanchez A, Luna del Castillo JD, Lardelli Claret P. [Validity and reliability of the Duke-UNC-11 questionnaire of functional social support]. Aten Primaria. 1996 Sep 15;18(4):153-6, 158-63. Spanish.

    PubMed 8962994
  • Broadhead WE, Gehlbach SH, de Gruy FV, Kaplan BH. The Duke-UNC Functional Social Support Questionnaire. Measurement of social support in family medicine patients. Med Care. 1988 Jul;26(7):709-23. doi: 10.1097/00005650-198807000-00006.

    PubMed 3393031
  • Morosini PL, Magliano L, Brambilla L, Ugolini S, Pioli R. Development, reliability and acceptability of a new version of the DSM-IV Social and Occupational Functioning Assessment Scale (SOFAS) to assess routine social functioning. Acta Psychiatr Scand. 2000 Apr;101(4):323-9.

    PubMed 10782554

Questions about this trial

What is this clinical trial studying?

A study testing Transitional discharge program in people with Readmission and Mental Health Disorder, run by Fundación Pública Andaluza para la Investigación de Málaga en Biomedicina y Salud at 1 site in Spain.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 7 inclusion and 6 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: status not confirmed, as of the sponsor's last update on 20 Sep 2024. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in Spain. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

Results are not available in the source record.

How can a doctor refer a patient or contact the research team?

Contact Vera Carbonell Aranda, Bachelor (695992369, vera.caar@hotmail.com), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Early readmission rate (time frame: Data will be collected over the 12 months following the implementation of the intervention program.). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT06604780, which also lists 24 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 20 Sep 2024.

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