Transitional interventions to reduce early psychiatric readmissions in adults: Systematic review

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 postdischarge 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. Copyright © BJP 2013.