Transitional interventions to reduce early psychiatric readmissions in adults: systematic review

BACKGROUND: Up to 13% of psychiatric patients are readmitted shortly after discharge. Interventions that ensure successful transitions to community care may play a key role in preventing early readmission. AIMS: To describe and evaluate interventions applied during the transition from in-patient to out-patient care in preventing early psychiatric readmission. METHOD: Systematic review of transitional interventions among adults admitted to hospital with mental illness where the study outcome was psychiatric readmission. RESULTS: The review included 15 studies with 15 non-overlapping intervention components. Absolute risk reductions of 13.6 to 37.0% were observed in statistically significant studies. Effective intervention components were: pre- and post-discharge patient psychoeducation, structured needs assessments, medication reconciliation/education, transition managers and in-patient/out-patient provider communication. Key limitations were small sample size and risk of bias. CONCLUSIONS: Many effective transitional intervention components are feasible and likely to be cost-effective. Future research can provide direction about the specific components necessary and/or sufficient for preventing early psychiatric readmission.