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Effectiveness of Transitional Interventions in Improving Patient Outcomes and Service Use After Discharge From
Anna Hegedüs1,2, Bernd Kozel2,3, Dirk Richter4,5
1Research Institute, Careum School of Health Ltd., Zurich, Switzerland.
Frontiers in Psychiatry
|February 11, 2020
Summary
Transitional interventions for psychiatric patients did not significantly reduce readmissions compared to usual care. More high-quality research is needed to confirm effectiveness, though patients prefer these bridging programs.
Area of Science:
- Psychiatry and Mental Health
- Health Services Research
- Evidence-Based Practice
Background:
- Psychiatric hospital discharge presents challenges to community adjustment and care continuity.
- Transitional interventions, bridging inpatient and community care, aim to improve outcomes and prevent readmissions.
- This study assessed the effectiveness of such interventions in reducing psychiatric readmissions.
Approach:
- A systematic review and meta-analysis of randomized controlled trials (RCTs) and other study designs were conducted.
- Searched multiple electronic databases for relevant studies on transitional interventions.
- Analyzed readmission rates and other health/social outcomes using random-effects meta-analysis for RCTs and qualitative synthesis for other designs.
Key Points:
- Sixteen studies, including 10 RCTs, were included; 9 RCTs were meta-analyzed.
- Interventions often combined case management, psychoeducation, and cognitive behavioral therapy.
- Transitional interventions showed an odds ratio of 0.76 for readmission, with low heterogeneity, but were not significantly more effective than usual care.
Conclusions:
- Current evidence suggests transitional interventions are not superior to usual care in reducing psychiatric readmissions.
- Limited evidence necessitates further high-quality research to definitively establish effectiveness.
- Despite inconclusive effectiveness, these interventions are favored by service users and may offer an alternative care strategy.
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