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Peer support for discharge from inpatient to community mental health services: Study protocol clinical trial (SPIRIT Compliant).

Gillard, S; Bremner, S; Foster, R; Gibson, SL; Goldsmith, L; Healey, A; Lucock, M; Marks, J; Morshead, R; Patel, A; et al. Gillard, S; Bremner, S; Foster, R; Gibson, SL; Goldsmith, L; Healey, A; Lucock, M; Marks, J; Morshead, R; Patel, A; Priebe, S; Repper, J; Rinaldi, M; Roberts, S; Simpson, A; White, S (2020) Peer support for discharge from inpatient to community mental health services: Study protocol clinical trial (SPIRIT Compliant). Medicine (Baltimore), 99 (10). e19192. ISSN 1536-5964 https://doi.org/10.1097/MD.0000000000019192
SGUL Authors: Gillard, Steven George White, Sarah Jane Goldsmith, Lucy Pollyanna

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Abstract

INTRODUCTION: In the period shortly after discharge from inpatient to community mental health care, people are at increased risk of self-harm, suicide, and readmission to hospital. Discharge interventions including peer support have shown potential, and there is some evidence that community-based peer support reduces readmissions. However, systematic reviews of peer support in mental health services indicate poor trial quality and a lack of reporting of how peer support is distinctive from other mental health support. This study is designed to establish the clinical and cost effectiveness of a peer worker intervention to support discharge from inpatient to community mental health care, and to address issues of trial quality and clarity of reporting of peer support interventions. METHODS: This protocol describes an individually randomized controlled superiority trial, hypothesizing that people offered a peer worker discharge intervention in addition to usual follow-up care in the community are less likely to be readmitted in the 12 months post discharge than people receiving usual care alone. A total of 590 people will be recruited shortly before discharge from hospital and randomly allocated to care as usual plus the peer worker intervention or care as usual alone. Manualized peer support provided by trained peer workers begins in hospital and continues for 4 months in the community post discharge. Secondary psychosocial outcomes are assessed at 4 months post discharge, and service use and cost outcomes at 12 months post discharge, alongside a mixed methods process evaluation. DISCUSSION: Clearly specified procedures for sequencing participant allocation and for blinding assessors to allocation, plus full reporting of outcomes, should reduce risk of bias in trial findings and contribute to improved quality in the peer support evidence base. The involvement of members of the study team with direct experience of peer support, mental distress, and using mental health services, in coproducing the intervention and designing the trial, ensures that we theorize and clearly describe the peer worker intervention, and evaluate how peer support is related to any change in outcome. This is an important methodological contribution to the evidence base. TRIAL REGISTRATION: This study was prospectively registered as ISRCTN 10043328 on November 28, 2016.

Item Type: Article
Additional Information: Copyright © 2020 the Author(s). Published by Wolters Kluwer Health, Inc. This is an open access article distributed under the Creative Commons Attribution License 4.0 (CCBY), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Keywords: 1103 Clinical Sciences, Arthritis & Rheumatology
SGUL Research Institute / Research Centre: Academic Structure > Population Health Research Institute (INPH)
Journal or Publication Title: Medicine (Baltimore)
ISSN: 1536-5964
Language: eng
Dates:
DateEvent
March 2020Published
15 January 2020Accepted
Publisher License: Creative Commons: Attribution 4.0
Projects:
Project IDFunderFunder ID
RP-PG-1212-20019National Institute for Health Researchhttp://dx.doi.org/10.13039/501100000272
PubMed ID: 32150057
Go to PubMed abstract
URI: http://openaccess.sgul.ac.uk/id/eprint/111773
Publisher's version: https://doi.org/10.1097/MD.0000000000019192

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