RT Journal Article
SR Electronic
T1 Combining brief contact interventions (BCI) into a decision-making algorithm to reduce suicide reattempt: the VigilanS study protocol
JF BMJ Open
JO BMJ Open
FD British Medical Journal Publishing Group
SP e022762
DO 10.1136/bmjopen-2018-022762
VO 8
IS 10
A1 Duhem, Stéphane
A1 Berrouiguet, Sofian
A1 Debien, Christophe
A1 Ducrocq, François
A1 Demarty, Anne Laure
A1 Messiah, Antoine
A1 Courtet, Philippe
A1 Jehel, Louis
A1 Thomas, Pierre
A1 Deplanque, Dominique
A1 Danel, Thierry
A1 Walter, Michel
A1 Notredame, Charles-Edouard
A1 Vaiva, Guillaume
YR 2018
UL http://bmjopen.bmj.com/content/8/10/e022762.abstract
AB Introduction The early postattempt period is considered to be one of the most at-risk time windows for suicide reattempt or completion. Among the postcrisis prevention programmes developed to compensate for this risk, brief contact interventions (BCIs) have been proven to be efficient but not equally for each subpopulation of attempters. VigilanS is a region-wide programme that relies on an algorithmic system to tailor surveillance and BCI provisions to individuals discharged from the hospital after a suicide attempt.Aim VigilanS’ main objective is to reduce suicide and suicide reattempt rates both at the individual level (patients included in VigilanS) and at the populational level (inhabitants of the Nord–Pas-de-Calais region).Methods and analysis At discharge, every attempter coming from a participating centre is given a crisis card with an emergency number to contact in case of distress. Patients are then systematically recontacted 6 months later. An additional 10-day call is also given if the index suicide attempt is not the first one. Depending on the clinical evaluation during the phone call, the call team may carry out proportionated crisis interventions. Personalised postcards are sent whenever patients are unreachable by phone or in distress. On the populational level, mean suicide and suicide attempt rates in Nord–Pas-de-Calais will be compared before and after the implementation of the programme. Here/there cross-sectional comparisons with a control region will test the spatial specificity of the observed fluctuations, while time-series analyses will be performed to corroborate the temporal plausibility of imputing these fluctuations to the implementation of the programme. On the individual level, patients entered in VigilanS will be prospectively compared with a matched control cohort by means of survival analyses (survival curve comparisons and Cox models).Discussion VigilanS interventional components fall under the ordinary law care regime, and the individuals’ general rights as patients apply with no addendums or restrictions for their participation in the programme. The research section received authorisation from the Ethical Committee of Lille Nord-Ouest under the caption ‘Study aimed at evaluating routine care’ and is registered in ‘Clinical Trials’. The French Ministry of Health plans to extend the experimentation to other regions and probe the relevance of this type of ‘bottom–up’ territorial prevention policy at the national level.Trial registration number NCT03134885.