Population-based outreach versus care as usual to prevent suicide attempt: study protocol for a randomized controlled trial

• DOI: 10.1186/s13063-016-1566-z
• Publication Date: 2016-09-15T11:24:20Z
• Authors: Gregory E. Simon; Arne Beck; Rebecca Rossom; Julie Richards; Beth Kirlin; Deborah King; Lisa Shulman; Evette J. Ludman; Robert Penfold; Susan M. Shortreed; Ursula Whiteside
• Keywords: Outreach

Suicide remains the 10th-ranked most frequent cause of death in United States, accounting for over 40,000 deaths per year. Nonfatal suicide attempts lead to 200,000 hospitalizations and 600,000 emergency department visits annually. Recent evidence indicates that responses commonly used Patient Health Questionnaire (PHQ9) can identify outpatients who are at risk attempt specific psychotherapy or Care Management programs prevent high-risk patients. Motivated by these developments, NIMH-funded Mental Research Network has undertaken a multisite trial two outreach among identified routinely administered PHQ9 questionnaires. Outpatients automatically using data from electronic health records (EHRs). Following modified Zelen design, all those assigned continued usual care (i.e., no contact) be offered one population-based programs. A intervention includes systematic assess risk, EHR-based tools implement risk-based pathways, management facilitate recommended follow-up. Skills Training interactive online training Dialectical Behavior Therapy skills, supported reminder reinforcement messages skills coach. Each supplements, rather than replaces, care; participants may receive any other services normally available. Interventions delivered primarily secure messaging through EHR patient portals. following randomization state vital statistics system insurance claim data. Primary evaluation will compare 18 months according initial assignment, regardless participation. Recruitment is underway three systems (Group Cooperative, HealthPartners, Kaiser Permanente Colorado). Over 2500 have been randomized as 1 March 2016, with enrollment averaging approximately 100 week. Assessing effectiveness prevention requires adherence principles pragmatic trials: enrollment, accepting variable treatment participation, assessing outcomes record data, analyses based on intent-to-treat. ClinicalTrials.gov registration # NCT02326883 , registered 23 December 2014.