Electronic protocol for suicide risk management in research participants

被引:20
作者
Belnap, Bea Herbeck [1 ]
Schulberg, Herbert C. [2 ]
He, Fanyin [3 ]
Mazumdar, Sati [3 ]
Reynolds, Charles F., III [4 ]
Rollman, Bruce L. [1 ]
机构
[1] Univ Pittsburgh, Sch Med, Div Gen Internal Med, Ctr Res Hlth Care, Pittsburgh, PA USA
[2] Weill Cornell Med Coll, Dept Psychiat, White Plains, NY USA
[3] Univ Pittsburgh, Grad Sch Publ Hlth, Dept Biostat, Pittsburgh, PA 15261 USA
[4] Univ Pittsburgh, Sch Med, Dept Psychiat, Pittsburgh, PA USA
关键词
Clinical trial; Coronary artery bypass graft; Depression; Suicidal ideation; Electronic research protocol; PRIMARY-CARE PATIENTS; DELIVERED COLLABORATIVE CARE; IDEATION; DEPRESSION; PREVENTION; SCALE; SYMPTOMS; VALIDITY; BEHAVIOR; PHQ-9;
D O I
10.1016/j.jpsychores.2014.12.012
中图分类号
R749 [精神病学];
学科分类号
100205 ;
摘要
Objective: To describe an electronic, telephone-delivered, suicide risk management protocol (SRMP) that is designed to guide research staff and safely triage study participants who are at risk for self-harm. Methods: We tested the SRMP in the context of the NIH-funded randomized clinical trial "Bypassing the Blues" in which 302 patients who had undergone coronary artery bypass graft surgery (CABG) were screened for depression and assessed by telephone 2-weeks following hospital discharge and at 2-, 4-, and 8-month follow-up. We programmed the SRMP to assign different risk levels based on patients' answers from none to imminent with action items for research staff keyed to each of them. We describe frequency of suicidal thinking, SRMP use, and completion of specific steps in the SRMP management process over the 8-month follow-up period. Results: Suicidal ideation was expressed by 74 (25%) of the 302 study participants in 139 (13%) of the 1069 blinded telephone assessments performed by research staff. The SRMP was launched in 103 (10%) of assessments, and the suicidal risk level was classified as moderate or high in 10 (1%) of these assessments, thereby necessitating an immediate evaluation by a study psychiatrist. However, no hospitalizations, emergency room visits, or deaths ascribed to suicidal ideation were discovered during the study period. Conclusion: The SRMP was successful in systematically and safely guiding research staff lacking specialty mental health training through the standardized risk assessment and triaging research participants at risk for self-harm. Published by Elsevier Inc.
引用
收藏
页码:340 / 345
页数:6
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