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Transitional interventions to reduce early psychiatric readmissions in adults: systematic review
Simone N Vigod1, Paul A Kurdyak, Cindy-Lee Dennis
1Women's College Hospital and Women's College Research Institute, Department of Psychiatry, University of Toronto, 76 Grenville Street Rm. 956, Toronto, ON, Canada M5S 1B2. simone.vigod@wchospital.ca
Background:
Up to 13% of psychiatric patients are readmitted shortly after discharge. Interventions that ensure successful transitions to community care may play a key role in preventing early readmission.
Aims:
To describe and evaluate interventions applied during the transition from in-patient to out-patient care in preventing early psychiatric readmission.
Method:
Systematic review of transitional interventions among adults admitted to hospital with mental illness where the study outcome was psychiatric readmission.
Results:
The review included 15 studies with 15 non-overlapping intervention components. Absolute risk reductions of 13.6 to 37.0% were observed in statistically significant studies. Effective intervention components were: pre- and post-discharge patient psychoeducation, structured needs assessments, medication reconciliation/education, transition managers and in-patient/out-patient provider communication. Key limitations were small sample size and risk of bias.
Conclusions:
Many effective transitional intervention components are feasible and likely to be cost-effective. Future research can provide direction about the specific components necessary and/or sufficient for preventing early psychiatric readmission.
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