Brief Interventions via Electronic Health Record Messaging for Population-Based Suicide Prevention: Mixed Methods Pilot Study.
Brief Interventions via Electronic Health Record Messaging for Population-Based Suicide Prevention: Mixed Methods Pilot Study.
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DOI：
10.2196/21127
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发表时间：
2021-04-12
影响因子：
2.2
通讯作者：
Simon GE
中科院分区：
文献类型：
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作者：
Whiteside U;Richards J;Simon GE
在卫生保健环境中，创建和评估基于人群的自杀行为选择性预防计划的新机会正在出现。记录在电子病历(EMR)中的标准抑郁症严重程度测量可以用来识别有自杀和自杀企图的风险的患者，在有希望的干预措施中降低有自杀企图的高危人群的风险可以被调整为基于网络的医疗保健服务。这项研究旨在评估心理教育项目的试点项目，重点是通过基于网络的辩证行为治疗(DBT)技能网站开发情绪调节技术，包括四项DBT技能，并得到安全信息指导的支持，包括关怀信息的元素。根据EMR记录的对患者健康问卷的回答，患者符合条件，表明有自杀想法。我们通过打开计划邀请、访问基于网络的同意表页面并表示同意的受邀者比例来衡量可行性；通过参与者对DBT计划的定性反馈来衡量可接受性；通过开始DBT技能的受邀者比例以及DBT技能的网站访问次数和网站参与度来衡量参与度。共有60名患者被邀请参加。总体而言，93%(56/60)的患者打开了邀请，43%(26/60)的患者同意参与。DBT技能网站用户平均访问主页5.3次(标清6.0)。程序的结果是没有投诉，一些参与者反馈强调DBT技能的有用性。这项研究支持在急诊医生中使用对患者健康问卷的回复来识别高危人群，并提供关爱信息和适应低强度干预的DBT的关键要素。目前正在进行一项评估该计划有效性的随机试验(ClinicalTrials.gov：NCT02326883)。
New opportunities to create and evaluate population-based selective prevention programs for suicidal behavior are emerging in health care settings. Standard depression severity measures recorded in electronic medical records (EMRs) can be used to identify patients at risk for suicide and suicide attempt, and promising interventions for reducing the risk of suicide attempt in at-risk populations can be adapted for web-based delivery in health care. This study aims to evaluate a pilot of a psychoeducational program, focused on developing emotion regulation techniques via a web-based dialectical behavior therapy (DBT) skills site, including four DBT skills, and supported by secure message coaching, including elements of caring messages. Patients were eligible based on the EMR-documented responses to the Patient Health Questionnaire indicating suicidal thoughts. We measured feasibility via the proportion of invitees who opened program invitations, visited the web-based consent form page, and consented; acceptability via qualitative feedback from participants about the DBT program; and engagement via the proportion of invitees who began DBT skills as well as the number of website visits for DBT skills and the degree of site engagement. A total of 60 patients were invited to participate. Overall, 93% (56/60) of the patients opened the invitation and 43% (26/60) consented to participate. DBT skills website users visited the home page on an average of 5.3 times (SD 6.0). Procedures resulted in no complaints and some participant feedback emphasizing the usefulness of DBT skills. This study supports the potential of using responses to patient health questionnaires in EMRs to identify a high-risk population and offer key elements of caring messages and DBT adapted for a low-intensity intervention. A randomized trial evaluating the effectiveness of this program is now underway (ClinicalTrials.gov: NCT02326883).