An Interactive Web-Based Lethal Means Safety Decision Aid for Suicidal Adults (Lock to Live): Pilot Randomized Controlled Trial.
firearm
internet
medication
suicide
Journal
Journal of medical Internet research
ISSN: 1438-8871
Titre abrégé: J Med Internet Res
Pays: Canada
ID NLM: 100959882
Informations de publication
Date de publication:
29 01 2020
29 01 2020
Historique:
received:
13
09
2019
accepted:
15
12
2019
revised:
15
11
2019
entrez:
4
2
2020
pubmed:
6
2
2020
medline:
28
7
2020
Statut:
epublish
Résumé
Counseling to reduce access to lethal means such as firearms and medications is recommended for suicidal adults but does not routinely occur. We developed the Web-based Lock to Live (L2L) decision aid to help suicidal adults and their families choose options for safer home storage. This study aimed to test the feasibility and acceptability of L2L among suicidal adults in emergency departments (EDs). At 4 EDs, we enrolled participants (English-speaking, community-dwelling, suicidal adults) in a pilot randomized controlled trial. Participants were randomized in a 13:7 ratio to L2L or control (website with general suicide prevention information) groups and received a 1-week follow-up telephone call. Baseline characteristics were similar between the intervention (n=33) and control (n=16) groups. At baseline, many participants reported having access to firearms (33/49, 67%), medications (46/49, 94%), or both (29/49, 59%). Participants viewed L2L for a median of 6 min (IQR 4-10 min). L2L also had very high acceptability; almost all participants reported that they would recommend it to someone in the same situation, that the options felt realistic, and that L2L was respectful of values about firearms. In an exploratory analysis of this pilot trial, more participants in the L2L group reported reduced firearm access at follow-up, although the differences were not statistically significant. The L2L decision aid appears feasible and acceptable for use among adults with suicide risk and may be a useful adjunct to lethal means counseling and other suicide prevention interventions. Future large-scale studies are needed to determine the effect on home access to lethal means. ClinicalTrials.gov NCT03478501; https://clinicaltrials.gov/ct2/show/NCT03478501.
Sections du résumé
BACKGROUND
Counseling to reduce access to lethal means such as firearms and medications is recommended for suicidal adults but does not routinely occur. We developed the Web-based Lock to Live (L2L) decision aid to help suicidal adults and their families choose options for safer home storage.
OBJECTIVE
This study aimed to test the feasibility and acceptability of L2L among suicidal adults in emergency departments (EDs).
METHODS
At 4 EDs, we enrolled participants (English-speaking, community-dwelling, suicidal adults) in a pilot randomized controlled trial. Participants were randomized in a 13:7 ratio to L2L or control (website with general suicide prevention information) groups and received a 1-week follow-up telephone call.
RESULTS
Baseline characteristics were similar between the intervention (n=33) and control (n=16) groups. At baseline, many participants reported having access to firearms (33/49, 67%), medications (46/49, 94%), or both (29/49, 59%). Participants viewed L2L for a median of 6 min (IQR 4-10 min). L2L also had very high acceptability; almost all participants reported that they would recommend it to someone in the same situation, that the options felt realistic, and that L2L was respectful of values about firearms. In an exploratory analysis of this pilot trial, more participants in the L2L group reported reduced firearm access at follow-up, although the differences were not statistically significant.
CONCLUSIONS
The L2L decision aid appears feasible and acceptable for use among adults with suicide risk and may be a useful adjunct to lethal means counseling and other suicide prevention interventions. Future large-scale studies are needed to determine the effect on home access to lethal means.
TRIAL REGISTRATION
ClinicalTrials.gov NCT03478501; https://clinicaltrials.gov/ct2/show/NCT03478501.
Identifiants
pubmed: 32012056
pii: v22i1e16253
doi: 10.2196/16253
pmc: PMC7016618
doi:
Banques de données
ClinicalTrials.gov
['NCT03478501']
Types de publication
Journal Article
Randomized Controlled Trial
Research Support, N.I.H., Extramural
Langues
eng
Sous-ensembles de citation
IM
Pagination
e16253Informations de copyright
©Marian E Betz, Christopher E Knoepke, Scott Simpson, Bonnie J Siry, Ashley Clement, Tamara Saunders, Rachel Johnson, Deborah Azrael, Edwin D Boudreaux, Faris Omeragic, Leah M Adams, Sydney Almond, Elizabeth Juarez-Colunga, Daniel D Matlock. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 29.01.2020.
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