Twelve months effect of self-referral to inpatient treatment on patient activation, recovery, symptoms and functioning: A randomized controlled study
Moljord, Inger Elise Opheim; Lara Cabrera, Mariela Loreto; Salvesen, Øyvind; Rise, Marit By; Bjørgen, Dagfinn; Antonsen, Dag Øivind; Olsø, Turid Møller; Evensen, Gretha Helen; Gudde, Camilla Buch; Linaker, Olav Morten; Steinsbekk, Aslak; Eriksen, Lasse
Peer reviewed, Journal article
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Date
2017Metadata
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Original version
Patient Education and Counseling. 2017, 100 (6), 1144-1152. 10.1016/j.pec.2017.01.008Abstract
Objective
To investigate the effect of having a contract for self-referral to inpatient treatment (SRIT) in patients with severe mental disorders.
Methods
A randomized controlled trial with 53 adult patients; 26 participants received a SRIT contract, which they could use to refer themselves into a Community Mental Health Centre up to five days for each referral without contacting a doctor in advance. Outcomes were assessed after 12 months with the self-report questionnaires Patient Activation Measure (PAM-13), Recovery Assessment Scale (RAS), and the Behavior and Symptom Identification Scale (BASIS-32) and analyzed using linear mixed and regression models.
Results
There was no significant effect on PAM-13 (estimated mean difference (emd) −0.41, 95% CI (CI):-7.49–6.67), nor on the RAS (emd 0.02, CI:-0.27–0.31) or BASIS-32 (0.09, CI:-0.28–0.45). An exploratory post hoc analysis showed effect of SRIT in those with low PAM below ≤47 (p = 0.049).
Conclusion
There were no group differences after 12 months, but both groups maintained their baseline levels.
Practice implications
SRIT contracts can be recommended as it supports the rights to self-determination, promote user participation in decision-making in own treatment without any indication of adverse effects.