Clinical trial NCT01374035: 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
Overall status: WITHDRAWN
Phase: NA
Conditions: Mental Disorders
Keywords: Health Service
Coordination
Referral letters
Mental Health
Adults
Lead sponsor: Helse Fonna
Sponsor class: OTHER
Collaborators: name: University of Bergen
name: KU Leuven
First posted: 2011-06-15
Enrollment: 0
Sex: ALL
Minimum age (years): 18
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Allocation: RANDOMIZED
Intervention model: PARALLEL
Primary purpose: HEALTH_SERVICES_RESEARCH

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.

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)

Primary outcomes:
measure: Length of stay
timeFrame: Day of discharge assessed up to six months
Secondary outcomes:
measure: Response time for referral letters in Specialised Mental Health Care
timeFrame: 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.
Other outcomes:
Locations:
city: Haugesund
country: Norway
facility: Helse Fonna Local Health Authorities
Study officials:
affiliation: Faculty of Medicine and Dentistery, University of Bergen, Norway
name: Aslak B Aslaksen, MD, PhD
role: STUDY_CHAIR
affiliation: Faculty of Medicine and Dentistery, University of Bergen, Norway
name: Kjell Haug, MD, PhD
role: PRINCIPAL_INVESTIGATOR
affiliation: KU Leuven
name: Kris Vanhaecht, RN, PhD
role: PRINCIPAL_INVESTIGATOR
References:
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.
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
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.
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.
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.