Kawanishi Chiaki, Ishii Takao, Yonemoto Naohiro, Yamada Mitsuhiko, Tachikawa Hirokazu, Kishimoto Toshifumi, Tsujii Noa, Hashimoto Satoshi, Kinoshita Toshihiko, Mimura Masaru, Okubo Yoshiro, Otsuka Kotaro, Yoshimura Reiji
Department of Neuropsychiatry, Sapporo Medical University Graduate School of Medicine.
Department of Biostatistics, Kyoto University School of Public Health, Kyoto, Japan.
BMJ Open. 2018 Oct 4;8(9):e020517. doi: 10.1136/bmjopen-2017-020517.
Suicide attempt is the most important risk factor for later suicide. A randomised-controlled, multicentre trial of postsuicide attempt case management for the prevention of further suicide attempts in Japan, named ACTION-J, has established effective interventions for prevention of suicide reattempts. The ACTION-J assertive case management intervention programme was adopted by the Japanese Ministry of Health, Labour and Welfare in 2016, when medical fees were revised. This nationwide programme is provided to patients who attempt suicide and who are admitted to emergency departments in Japan.The aim of the present study is to examine the current implementation status of the ACTION-J programme. The present study also aims to clarify which patients' and hospitals' factors affect the implementation of the programme.
This is a prospective, multicentre, patient registry cohort study. Participants will be suicide attempters admitted to the emergency departments of medical facilities with both psychiatry and emergency departments. The assertive case management programme will be delivered to participants by a case manager for up to 24 weeks, based on psychiatric diagnoses, social risks and patient needs. The core feature of the programme is to encourage patients to participate in psychiatric treatment.The primary outcome will be the proportion of patients still participating in the case management intervention at 24 weeks after registration. The secondary outcomes will include measures of the fidelity of the case management intervention. The fidelity will be evaluated using a fidelity assessment manual developed by the study group.
This observational study has been approved by the ethics board of Sapporo Medical University. Enrolment began in October 2016 and will continue until December 2018. Dissemination plans include presentations at scientific conferences and scientific publications.
UMIN000024474.
自杀未遂是日后自杀最重要的风险因素。在日本开展了一项名为ACTION-J的随机对照多中心试验，旨在对自杀未遂案例进行管理，以预防再次自杀未遂，该试验已确立了预防自杀再尝试的有效干预措施。2016年日本厚生劳动省修订医疗费时采用了ACTION-J积极案例管理干预项目。这个全国性项目面向在日本因自杀未遂而入住急诊科的患者。本研究的目的是调查ACTION-J项目目前的实施状况。本研究还旨在阐明哪些患者因素和医院因素会影响该项目的实施。
这是一项前瞻性、多中心、患者注册队列研究。研究对象将是入住设有精神科和急诊科的医疗机构急诊科的自杀未遂者。基于精神科诊断、社会风险和患者需求，由个案管理员向研究对象提供积极案例管理项目，为期最长24周。该项目的核心特点是鼓励患者参与精神科治疗。主要结局将是登记后24周时仍参与案例管理干预的患者比例。次要结局将包括案例管理干预的保真度测量。将使用研究小组制定的保真度评估手册对保真度进行评估。
这项观察性研究已获得札幌医科大学伦理委员会的批准。入组于2016年10月开始，将持续至2018年12月。传播计划包括在科学会议上发表演讲和发表科学论文。
UMIN000024474。
