Patient-centred education

Abstract

Background: People who have attempted suicide are at high risk of further suicide attempts. Telephone-delivered interventions have merits of easily accessible and costeffectiveness, and may be useful in follow-up management of suicide attempters. Objective: To assess the efficacy of telephone-delivered interventions for preventing suicide re-attempts in suicide attempters. Methods: We searched PubMed, EMBASE, Cochrane Library, and PsycINFO to April 2014. This review included randomized controlled trials comparing telephone-delivered interventions for preventing suicide re-attempts with usual care in suicide attempters. Studies which used phones for calling or messaging or as a part of their intervention were included. But studies which are unclear whether they used phones were excluded. Two independent reviewers appraised study quality and extracted data. Results: Out of 142 studies, 7 studies were included in this review. Studies had good methodological quality features, and were categorized as telephone contact (n ¼ 3), crisis card which enable 24-hour crisis telephone consultation (n ¼ 2), mixed (phone plus other interventions) (n ¼ 2). Meta-analyses found that telephone contact did not significantly reduce proportion of repeaters (RR 0.78, 95% CI 0.58 to 1.07), deaths by suicide (RR 0.70, 95% CI 0.12 to 4.16), and losses to follow-up (RR 0.86, 95% CI 0.68 to 1.08) during the following year. One of the telephone contact studies proved effect in psychological symptom. Crisis card showed no significant effect on proportion of repeaters (RR 0.64, 95% CI 0.27 to 1.54). Although mixed interventions were not effective in repeated suicide attempt, one of them was effective in suicidal ideation and depression. Discussion: There was little evidence that telephonedelivered interventions can effect in suicide attempters. Most of included studies provided brief and a few times interventions, so more aggressive interventions are required. Conclusion: Telephone-delivered interventions may have a role in reducing suicidal ideation, depression, and psychological symptom, but there is a need for more research because current evidence is scarce.