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.

Abstract

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.

Publication types

  • Review
  • Systematic Review

MeSH terms

  • Adult
  • Ambulatory Care / organization & administration
  • Cohort Studies
  • Continuity of Patient Care / organization & administration*
  • Continuity of Patient Care / standards
  • Controlled Clinical Trials as Topic
  • Hospitals, Psychiatric*
  • Humans
  • Medication Reconciliation
  • Mental Disorders / therapy*
  • Needs Assessment
  • Patient Discharge*
  • Patient Education as Topic
  • Patient Readmission / statistics & numerical data*
  • Quality Indicators, Health Care*
  • United States