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The Western Norway Mental Health Interface Study on Referral Letters

Primary Purpose

Mental Disorders

Status
Withdrawn
Phase
Not Applicable
Locations
Norway
Study Type
Interventional
Intervention
Quality improvement intervention
Sponsored by
Helse Fonna
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional health services research trial for Mental Disorders focused on measuring Health Service, Coordination, Referral letters, Mental Health, Adults

Eligibility Criteria

18 Years - undefined (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  • Referral letters send from a GP to Public Specialised Mental Health Care
  • Referrals for elective assessment or treatment

Exclusion Criteria:

  • Referral letters send from other health personnel
  • Referrals for acute care (within 24 hours)

Sites / Locations

  • Helse Fonna Local Health Authorities

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

No Intervention

Arm Label

Participating GPs

Control group

Arm Description

GPs working at randomly selected GP centers/offices within the region that are invited to participate and signs a written informed consent to participate. (N=30-40)

GPs working at randomly selected GP centers/office within the region that are not invited to participate, will form the control group. (N=30-40)

Outcomes

Primary Outcome Measures

Length of stay
From date of admission or onset of out-patient treatment until date of discharge (documented in Electronic Patient Record as end of treatment periode), assessed up to six months from admission.

Secondary Outcome Measures

Response time for referral letters in Specialised Mental Health Care
Unit of measure: Number of days from receiving a referral letter to the response letter is sent to the patient and the General Practitioner. The response time for all letters recieved in a six month periode before the intervention to improve the quality of referral letters will be compared with the response time after the intervention.

Full Information

First Posted
April 28, 2011
Last Updated
February 11, 2020
Sponsor
Helse Fonna
Collaborators
University of Bergen, KU Leuven
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1. Study Identification

Unique Protocol Identification Number
NCT01374035
Brief Title
The Western Norway Mental Health Interface Study on Referral Letters
Official Title
Interface Between Primary Care and Specialist Mental Health Care - the Referral Letters
Study Type
Interventional

2. Study Status

Record Verification Date
February 2020
Overall Recruitment Status
Withdrawn
Why Stopped
Were not able to conduct the intervention.
Study Start Date
August 1, 2010 (Actual)
Primary Completion Date
June 22, 2016 (Actual)
Study Completion Date
December 13, 2019 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
Helse Fonna
Collaborators
University of Bergen, KU Leuven

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
The main object to this trial is to study the function of referral letters as a mean to coordinate the care process for adult people when referred from Primary Care to Specialised Mental Health Care. The study will explore if and to what degree the quality of these referral letters can be improved, and the potential improvement's impact on defined patient-, professional and organisational related outcomes. According to Medical Research Council guidelines for evaluating complex interventions, a stepwise design with the use of both qualitative and quantitative methods will be used to conduct a controlled intervention study.
Detailed Description
The study is based on a stepwise progression including four steps. Within step one group interview with four mixed groups of health professionals (both Primary and Specialised Care), patient representatives and managers will be conducted. The groups will give input on firstly, what information they think is important to include in the referral letters, and secondly, what impact they think improved referral letters can have for the organisation and care within Specialised Mental Health Care. Within step two a validated check-list to assess the quality of referral letters will be developed. Within step three outcome measures will be developed and tested. Both step two and three will make use of the results from step one in addition to existing literature and testing. Step four is the intervention study where measures from the former steps will be used.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Mental Disorders
Keywords
Health Service, Coordination, Referral letters, Mental Health, Adults

7. Study Design

Primary Purpose
Health Services Research
Study Phase
Not Applicable
Interventional Study Model
Parallel Assignment
Masking
Outcomes Assessor
Allocation
Randomized
Enrollment
0 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Participating GPs
Arm Type
Experimental
Arm Description
GPs working at randomly selected GP centers/offices within the region that are invited to participate and signs a written informed consent to participate. (N=30-40)
Arm Title
Control group
Arm Type
No Intervention
Arm Description
GPs working at randomly selected GP centers/office within the region that are not invited to participate, will form the control group. (N=30-40)
Intervention Type
Other
Intervention Name(s)
Quality improvement intervention
Intervention Description
A complex intervention will be implemented within the group of GPs in the intervention group. It includes participation in defining criteria for good referral letters, information about the correlation between information in the referral letters and outcome, introduction to the guideline, and consecutive feedback on own preformance regarding content of referral letter and outcome for the patient.
Primary Outcome Measure Information:
Title
Length of stay
Description
From date of admission or onset of out-patient treatment until date of discharge (documented in Electronic Patient Record as end of treatment periode), assessed up to six months from admission.
Time Frame
Day of discharge assessed up to six months
Secondary Outcome Measure Information:
Title
Response time for referral letters in Specialised Mental Health Care
Description
Unit of measure: Number of days from receiving a referral letter to the response letter is sent to the patient and the General Practitioner. The response time for all letters recieved in a six month periode before the intervention to improve the quality of referral letters will be compared with the response time after the intervention.
Time Frame
Referral letters will be followed for the duration of the assessment and prioritation process until response letter is sent, an expected avarage of 10 days.

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Referral letters send from a GP to Public Specialised Mental Health Care Referrals for elective assessment or treatment Exclusion Criteria: Referral letters send from other health personnel Referrals for acute care (within 24 hours)
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Aslak B Aslaksen, MD, PhD
Organizational Affiliation
Faculty of Medicine and Dentistery, University of Bergen, Norway
Official's Role
Study Chair
First Name & Middle Initial & Last Name & Degree
Kjell Haug, MD, PhD
Organizational Affiliation
Faculty of Medicine and Dentistery, University of Bergen, Norway
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Kris Vanhaecht, RN, PhD
Organizational Affiliation
KU Leuven
Official's Role
Principal Investigator
Facility Information:
Facility Name
Helse Fonna Local Health Authorities
City
Haugesund
ZIP/Postal Code
5504
Country
Norway

12. IPD Sharing Statement

Plan to Share IPD
No
Citations:
PubMed Identifier
22081994
Citation
Hartveit M, Biringer E, Vanhaeht K, Haug K, Aslaksen A. The Western Norway mental health interface study: a controlled intervention trial on referral letters between primary care and specialist mental health care. BMC Psychiatry. 2011 Nov 14;11:177. doi: 10.1186/1471-244X-11-177.
Results Reference
background
Citation
Hartveit M, Aslaksen A, Vanhaecht K, Thorsen O, Hove O, Haug K et al. Development and testing of an instrument in Western Norway to measure the quality of referral information from primary care to specialised mental health care. International Journal of Care Coordination18:2-3, 2015
Results Reference
background
PubMed Identifier
28049470
Citation
Hartveit M, Vanhaecht K, Thorsen O, Biringer E, Haug K, Aslaksen A. Quality indicators for the referral process from primary to specialised mental health care: an explorative study in accordance with the RAND appropriateness method. BMC Health Serv Res. 2017 Jan 3;17(1):4. doi: 10.1186/s12913-016-1941-1.
Results Reference
background
PubMed Identifier
23958371
Citation
Hartveit M, Thorsen O, Biringer E, Vanhaecht K, Carlsen B, Aslaksen A. Recommended content of referral letters from general practitioners to specialised mental health care: a qualitative multi-perspective study. BMC Health Serv Res. 2013 Aug 19;13:329. doi: 10.1186/1472-6963-13-329.
Results Reference
result
PubMed Identifier
35655302
Citation
Nymoen M, Biringer E, Hetlevik O, Thorsen O, Assmus J, Hartveit M. The impact of referral letter quality on timely access to specialised mental health care: a quantitative study of the reliability of patient triage. BMC Health Serv Res. 2022 Jun 2;22(1):735. doi: 10.1186/s12913-022-08139-3.
Results Reference
derived

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The Western Norway Mental Health Interface Study on Referral Letters

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