Efficacy of a short message service brief contact intervention (SMS-SOS) in reducing repetition of hospital-treated self-harm: randomised controlled trial.

Self-harm aftercare out-patient treatment prevention randomised controlled trial

Journal

The British journal of psychiatry : the journal of mental science
ISSN: 1472-1465
Titre abrégé: Br J Psychiatry
Pays: England
ID NLM: 0342367

Informations de publication

Date de publication:
12 Dec 2023
Historique:
medline: 12 12 2023
pubmed: 12 12 2023
entrez: 12 12 2023
Statut: aheadofprint

Résumé

Hospital-treated self-harm is common and costly, and is associated with repeated self-harm and suicide. To investigate the effectiveness of a brief contact intervention delivered via short message service (SMS) text messages in reducing hospital-treated self-harm re-presentations in three hospitals in Sydney (2017-2019), Australia. Trial registration number: ACTRN12617000607370. A randomised controlled trial with parallel arms allocated 804 participants presenting with self-harm, stratified by previous self-harm, to a control condition of treatment as usual (TAU) ( The event rate for self-harm repetition was lower for the SMS compared with TAU group at 6 months (IRR = 0.79, 95% CI 0.61-1.01), 12 months (IRR = 0.78, 95% CI 0.64-0.95) and 24 months (IRR = 0.78, 95% CI 0.66-0.91). There was no difference between the SMS and TAU groups in the time to first repeat self-harm event over 24 months (HR = 0.96, 95% CI 0.72-1.26). There were four suicides in the TAU group and none in the SMS group. The 22% reduction in repetition of hospital-treated self-harm was clinically meaningful. SMS text messages are an inexpensive, scalable and universal intervention that can be used in hospital-treated self-harm populations but further work is needed to establish efficacy and cost-effectiveness across settings.

Sections du résumé

BACKGROUND BACKGROUND
Hospital-treated self-harm is common and costly, and is associated with repeated self-harm and suicide.
AIMS OBJECTIVE
To investigate the effectiveness of a brief contact intervention delivered via short message service (SMS) text messages in reducing hospital-treated self-harm re-presentations in three hospitals in Sydney (2017-2019), Australia. Trial registration number: ACTRN12617000607370.
METHOD METHODS
A randomised controlled trial with parallel arms allocated 804 participants presenting with self-harm, stratified by previous self-harm, to a control condition of treatment as usual (TAU) (
RESULTS RESULTS
The event rate for self-harm repetition was lower for the SMS compared with TAU group at 6 months (IRR = 0.79, 95% CI 0.61-1.01), 12 months (IRR = 0.78, 95% CI 0.64-0.95) and 24 months (IRR = 0.78, 95% CI 0.66-0.91). There was no difference between the SMS and TAU groups in the time to first repeat self-harm event over 24 months (HR = 0.96, 95% CI 0.72-1.26). There were four suicides in the TAU group and none in the SMS group.
CONCLUSIONS CONCLUSIONS
The 22% reduction in repetition of hospital-treated self-harm was clinically meaningful. SMS text messages are an inexpensive, scalable and universal intervention that can be used in hospital-treated self-harm populations but further work is needed to establish efficacy and cost-effectiveness across settings.

Identifiants

pubmed: 38083861
doi: 10.1192/bjp.2023.152
pii: S0007125023001526
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

1-8

Auteurs

Garry John Stevens (GJ)

School of Social Sciences, Western Sydney University, Penrith, New South Wales, Australia.

Sandro Sperandei (S)

Translational Health Research Institute, Western Sydney University, Penrith, New South Wales, Australia.

Gregory Leigh Carter (GL)

School of Medicine and Public Health, University of Newcastle, Callaghan, New South Wales, Australia.

Sithum Munasinghe (S)

Translational Health Research Institute, Western Sydney University, Penrith, New South Wales, Australia.

Trent Ernest Hammond (TE)

Nepean Clinical School, Faculty of Medicine and Health, University of Sydney, Penrith, New South Wales, Australia.

Naren Gunja (N)

Westmead Clinical School, Faculty of Medicine and Health, University of Sydney, Westmead, New South Wales, Australia; and Emergency Department, Westmead Hospital, Westmead, New South Wales, Australia.

Anabel de la Riva (A)

Westmead Hospital, Western Sydney Local Health District, Westmead, New South Wales, Australia.

Vlasios Brakoulias (V)

Nepean Clinical School, Faculty of Medicine and Health, University of Sydney, Penrith, New South Wales, Australia.

Andrew Page (A)

Translational Health Research Institute, Western Sydney University, Penrith, New South Wales, Australia.

Classifications MeSH