Sustain and Reinforce the Transition From Child to Adult Mental Health Care in Switzerland : A Monocentric Nested Cohort Randomized Controlled Trial: The SORT Study.
NCT ID: NCT04249960
Last Updated: 2020-01-31
Study Results
Results pending
The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.
Basic Information
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Recruitment Status
UNKNOWN
Clinical Phase
NA
Total Enrollment
200 participants
Study Classification
INTERVENTIONAL
Study Start Date
2019-10-09
Study Completion Date
2022-02-28
Brief Summary
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Disruption of care during transition from child and adolescent mental health (CAMHS) to adult mental health services (AMHS) may adversely affect the health and well-being of service users. Indeed, transition-related discontinuity of care is a major health and societal challenge today. Current evidences show that this transition is not always properly managed and that improving the transition process can have a positive impact on the health and wellbeing of young people. Nevertheless, data available are still inconsistent and only few studies investigated possible models aimed at improving and operationalize the transition. At present, no information concerning the transition in the Geneva Canton is available.
According to this lack of evidence, the current study aims at: 1) mapping the CAMHS/AMHS interface; 2) evaluating the longitudinal course and outcomes of adolescents approaching the transition boundary (TB) of their CAMHS; 3) determining the effectiveness of an experimental model of managed transition in improving outcomes, compared with usual care; 4) comparing these results with those of the EU funded MILESTONE study from several other European countries.
The investigators will recruit all patients aged ≥ 16 years and 6 months from the Geneva Canton in charge at CAMHS and they will follow them for up to 24 months. CAMHS will be instructed to provide all their service users at the time of transition either usual care or a novel service called "Managed Transition", which will include the use of a new decision support tool, the Transition Readiness and Appropriateness Measure (TRAM). A nested cohort Randomised Controlled Trial (ncRCT) design will be applied to divide patients into the two groups. The health and wellbeing of the young people will be assessed at baseline and then followed-up for 24 months to see whether they transition to AMHS or are discharged or referred to some other service. The investigators will then evaluate what impact the different transition experiences have on young people's health and wellbeing, and whether the process of Managed Transition has any benefits as compared to usual care.
According to this lack of evidence, the current study aims at: 1) mapping the CAMHS/AMHS interface; 2) evaluating the longitudinal course and outcomes of adolescents approaching the transition boundary (TB) of their CAMHS; 3) determining the effectiveness of an experimental model of managed transition in improving outcomes, compared with usual care; 4) comparing these results with those of the EU funded MILESTONE study from several other European countries.
The investigators will recruit all patients aged ≥ 16 years and 6 months from the Geneva Canton in charge at CAMHS and they will follow them for up to 24 months. CAMHS will be instructed to provide all their service users at the time of transition either usual care or a novel service called "Managed Transition", which will include the use of a new decision support tool, the Transition Readiness and Appropriateness Measure (TRAM). A nested cohort Randomised Controlled Trial (ncRCT) design will be applied to divide patients into the two groups. The health and wellbeing of the young people will be assessed at baseline and then followed-up for 24 months to see whether they transition to AMHS or are discharged or referred to some other service. The investigators will then evaluate what impact the different transition experiences have on young people's health and wellbeing, and whether the process of Managed Transition has any benefits as compared to usual care.
Detailed Description
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Conditions
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Psychiatric Disorder
Transition
Keywords
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adolescents
psychiatric disorders
CAMHS
AMHS
transition
Study Design
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Allocation Method
RANDOMIZED
Intervention Model
PARALLEL
Primary Study Purpose
SUPPORTIVE_CARE
Blinding Strategy
DOUBLE
Participants
Caregivers
Study Groups
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Transition as usual
Young people in this group will receive usual care and transition as usual, they will be our control group.
Group Type
NO_INTERVENTION
No interventions assigned to this group
Managed transition
Young people in this group will do the managed transition, they will be our experimental group.
Group Type
EXPERIMENTAL
Managed transition
Intervention Type
BEHAVIORAL
Young people, their family and clinicians will receive transition guidelines and will be asked to follow them as much as possible.
Interventions
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Managed transition
Young people, their family and clinicians will receive transition guidelines and will be asked to follow them as much as possible.
Intervention Type
BEHAVIORAL
Eligibility Criteria
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Inclusion Criteria
* 1\) provides valid written informed consent, or assent, if below the legal age of consent;
* 2\) age is within 18 months of reaching the transition boundary of their CAMHS - during the trial recruitment period;
* 3\) has a mental disorder defined by DSM-IV-TR, DSM-5 or ICD 10/11, or is under the regular care of CAMHS (if not yet diagnosed);
* 4\) Has an IQ ≥ 70 as ascertained by previous standardized assessment or diagnosed by clinician, or no indication of intellectual impairment.
* 2\) age is within 18 months of reaching the transition boundary of their CAMHS - during the trial recruitment period;
* 3\) has a mental disorder defined by DSM-IV-TR, DSM-5 or ICD 10/11, or is under the regular care of CAMHS (if not yet diagnosed);
* 4\) Has an IQ ≥ 70 as ascertained by previous standardized assessment or diagnosed by clinician, or no indication of intellectual impairment.
Exclusion Criteria
* 1\) does not provide valid written informed consent, or assent, if below the legal age of consent;
* 2\) is younger than 18 months before the transition boundary of their CAMHS;
* 3\) has intellectual impairment (IQ \< 70) as ascertained by standardized assessment or diagnosed by clinician;
* 4\) if not able to (or expected not to be able to) complete the questionnaires due to severe physical disabilities or language problems, even with assistance from family members or research assistant.
* 2\) is younger than 18 months before the transition boundary of their CAMHS;
* 3\) has intellectual impairment (IQ \< 70) as ascertained by standardized assessment or diagnosed by clinician;
* 4\) if not able to (or expected not to be able to) complete the questionnaires due to severe physical disabilities or language problems, even with assistance from family members or research assistant.
Minimum Eligible Age
16 Years
Maximum Eligible Age
18 Years
Eligible Sex
ALL
Accepts Healthy Volunteers
No
Sponsors
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University of Geneva, Switzerland
OTHER
Sponsor Role
lead
Responsible Party
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Dr Marco Armando
Principal Investigator
Responsibility Role
PRINCIPAL_INVESTIGATOR
Locations
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University of Geneva
Geneva, , Switzerland
Site Status
RECRUITING
Countries
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Switzerland
Central Contacts
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Facility Contacts
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Marco Armando, MD, PhD
Role: primary
References
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Related Links
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https://www.rcpsych.ac.uk/docs/default-source/improving-care/better-mh-policy/college-reports/college-report-cr182.pdf?sfvrsn=8662b58f_2
UK Guidelines on transition in mental health
https://www.nice.org.uk/guidance/ng43/evidence/full-guideline-pdf-2360240173
NICE Guidelines on transition in mental health
Other Identifiers
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2019-0853
Identifier Type: -
Identifier Source: org_study_id