title: Postcards from the EDge: 5-year outcomes of a randomised controlled trial for hospital-treated self-poisoning.
abstract: BACKGROUND
  Repetition of hospital-treated self-poisoning and admission to psychiatric hospital are both common in individuals who self-poison.
  
  
  OBJECTIVE
  To evaluate efficacy of postcard intervention after 5 years.
  
  
  METHODS
  A randomised controlled trial of individuals who have self-poisoned: postcard intervention (eight in 12 months) plus treatment as usual v. treatment as usual. Our primary outcomes were self-poisoning admissions and psychiatric admissions (proportions and event rates).
  
  
  RESULTS
  There was no difference between groups for any repeat-episode self-poisoning admission (intervention group: 24.9%, 95% CI 20.6-29.5; control group: 27.2%, 95% CI 22.8-31.8) but there was a significant reduction in event rates (incidence risk ratio (IRR) = 0.54, 95% CI 0.37-0.81), saving 306 bed days. There was no difference for any psychiatric admission (intervention group: 38.1%, 95% CI 33.1-43.2; control group: 35.5%, 95% CI 30.8-40.5) but there was a significant reduction in event rates (IRR = 0.66, 95% CI 0.47-0.91), saving 2565 bed days.
  
  
  CONCLUSIONS
  A postcard intervention halved self-poisoning events and reduced psychiatric admissions by a third after 5 years. Substantial savings occurred in general hospital and psychiatric hospital bed days.
authors.affiliation: Centre for Translational Neuroscience and Mental Health, Faculty of Health, University of Newcastle, Newcastle, Australia. gregory.carter@newcastle.edu.au
authors.forename: Gregory L
authors.initials: GL
authors.lastname: Carter
authors.forename: Kerrie
authors.initials: K
authors.lastname: Clover
authors.forename: Ian M
authors.initials: IM
authors.lastname: Whyte
authors.forename: Andrew H
authors.initials: AH
authors.lastname: Dawson
authors.forename: Catherine
authors.initials: C
authors.lastname: D'Este
mesh_terms: D000328:Adult; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data*; D006778:Hospitals, Psychiatric / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D009517:New South Wales / Q000453:epidemiology; D011041:Poisoning / Q000401:mortality / Q000628:therapy*; D011177:Postal Service; D017010:Reminder Systems; D055502:Secondary Prevention; D016728:Self-Injurious Behavior / Q000401:mortality / Q000628:therapy*; D016896:Treatment Outcome; D055815:Young Adult