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class="bkr_bib"><h1 id="_NBK588195_"><span itemprop="name">Evidence review for safer prescribing</span></h1><div class="subtitle">Self-harm: assessment, management and preventing recurrence</div><p><b>Evidence review O</b></p><p><i>NICE Guideline, No. 225</i></p><div class="half_rhythm">London: <a href="https://www.nice.org.uk" ref="pagearea=meta&targetsite=external&targetcat=link&targettype=publisher"><span itemprop="publisher">National Institute for Health and Care Excellence (NICE)</span></a>; <span itemprop="datePublished">2022 Sep</span>.<div class="small">ISBN-13: <span itemprop="isbn">978-1-4731-4702-7</span></div></div><div><a href="/books/about/copyright/">Copyright</a> © NICE 2022.</div></div><div class="bkr_clear"></div></div><div id="bcms6510.s1"><h2 id="_bcms6510_s1_">Safer prescribing</h2><div id="bcms6510.s1.1"><h3>Review question</h3><p>What are the key principles of safer prescribing for people who have self-harmed?</p><div id="bcms6510.s1.1.1"><h4>Introduction</h4><p>According to the National Confidential Inquiry into Suicide and Homicide by People with Mental Illness 2015, self-harm by self-poisoning is the second most common method of self-harm. Some medications, such as opioids and tricyclic anti-depressants, in overdose can be fatal. Many people who have harmed themselves will have been prescribed medications for physical and/ or mental health-related problems, or will have access to the medications of others close to them. As a result, there is the potential for people who have self-harmed using other methods to self-poison in the future if they have access to medications that are harmful in overdose. It is therefore imperative to review the evidence on what constitutes safe prescribing to reduce rates of self-poisoning from any medication that could potentially cause harm through overdose. The aim of this review is to identify the key principles of safer prescribing for people who have self-harmed using any method.</p></div><div id="bcms6510.s1.1.2"><h4>Summary of the protocol</h4><p>See <a class="figpopup" href="/books/NBK588195/table/bcms6510.tab1/?report=objectonly" target="object" rid-figpopup="figbcms6510tab1" rid-ob="figobbcms6510tab1">Table 1</a> for a summary of the Population, Intervention, Comparison and Outcome (PICO) characteristics of this review.</p><div class="iconblock whole_rhythm clearfix ten_col table-wrap" id="figbcms6510tab1"><a href="/books/NBK588195/table/bcms6510.tab1/?report=objectonly" target="object" title="Table 1" class="img_link icnblk_img figpopup" rid-figpopup="figbcms6510tab1" rid-ob="figobbcms6510tab1"><img class="small-thumb" src="/books/NBK588195/table/bcms6510.tab1/?report=thumb" src-large="/books/NBK588195/table/bcms6510.tab1/?report=previmg" alt="Table 1. Summary of the protocol (PICO table)." /></a><div class="icnblk_cntnt"><h4 id="bcms6510.tab1"><a href="/books/NBK588195/table/bcms6510.tab1/?report=objectonly" target="object" rid-ob="figobbcms6510tab1">Table 1</a></h4><p class="float-caption no_bottom_margin">Summary of the protocol (PICO table). </p></div></div><p>For further details see the review protocol in <a href="#bcms6510.appa">appendix A</a>.</p></div><div id="bcms6510.s1.1.3"><h4>Methods and process</h4><p>A modified version of the GRADE approach to rate the certainty of evidence in systematic reviews was used as part of a pilot project undertaken by NICE. Instead of using predefined clinical decision/minimal important difference (MID) thresholds to assess imprecision in GRADE tables, imprecision was assessed qualitatively during committee discussions. Other than this modification, GRADE was used to assess the quality of evidence for the selected outcomes and this evidence review was developed using the methods and process described in <a href="https://www.nice.org.uk/process/pmg20/chapter/introduction" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Developing NICE guidelines: the manual</a>. Methods specific to this review question are described in the review protocol in <a href="#bcms6510.appa">appendix A</a> and the <a href="/books/NBK588195/bin/NG225_Supplement1_Methods.pdf">methods</a> document (supplementary document 1).</p><p>Declarations of interest were recorded according to <a href="https://www.nice.org.uk/about/who-we-are/policies-and-procedures" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">NICE’s conflicts of interest policy</a>.</p></div><div id="bcms6510.s1.1.4"><h4>Effectiveness evidence</h4><div id="bcms6510.s1.1.4.1"><h5>Included studies</h5><p>A systematic review of the literature was conducted but no studies were identified which were applicable to this review question.</p><p>See the literature search strategy in <a href="#bcms6510.appb">appendix B</a> and study selection flow chart in <a href="#bcms6510.appc">appendix C</a>.</p></div><div id="bcms6510.s1.1.4.2"><h5>Excluded studies</h5><p>Studies not included in this review are listed, and reasons for their exclusion are provided in <a href="#bcms6510.appj">appendix J</a>.</p></div></div><div id="bcms6510.s1.1.5"><h4>Summary of included studies</h4><p>No studies were identified which were applicable to this review question (and so there are no evidence tables in <a href="#bcms6510.appd">Appendix D</a>).</p></div><div id="bcms6510.s1.1.6"><h4>Summary of the evidence</h4><p>No studies were identified which were applicable to this review question (and so there are no GRADE tables in <a href="#bcms6510.appf">Appendix F</a>).</p></div><div id="bcms6510.s1.1.7"><h4>Economic evidence</h4><div id="bcms6510.s1.1.7.1"><h5>Included studies</h5><p>A single economic search was undertaken for all topics included in the scope of this guideline but no economic studies were identified which were applicable to this review question. See the literature search strategy in <a href="#bcms6510.appb">appendix B</a> and economic study selection flow chart in <a href="#bcms6510.appg">appendix G</a>.</p></div><div id="bcms6510.s1.1.7.2"><h5>Excluded studies</h5><p>Economic studies not included in the guideline economic literature review are listed, and reasons for their exclusion are provided in <a href="#bcms6510.appj">appendix J</a>.</p></div></div><div id="bcms6510.s1.1.8"><h4>Economic model</h4><p>No economic modelling was undertaken for this review because the committee agreed that other topics were higher priorities for economic evaluation.</p></div><div id="bcms6510.s1.1.9"><h4>Evidence statements</h4><div id="bcms6510.s1.1.9.1"><h5>Economic</h5><p>No economic studies were identified which were applicable to this review question.</p></div></div><div id="bcms6510.s1.1.10"><h4>The committee’s discussion and interpretation of the evidence</h4><div id="bcms6510.s1.1.10.1"><h5>The outcomes that matter most</h5><p>Self-harm repetition, suicide and adverse events relating to prescribed drugs were prioritised as critical outcomes by the committee. Self-harm repetition and suicide were prioritised as critical outcomes because they are direct measures of any differential effectiveness associated with the interventions and capture both fatal and non-fatal self-harm. Occurrence of adverse events of prescribed drugs (such as self-poisoning or overdose, accidental or intentional) was chosen as a critical outcomes as it is associated with inappropriate prescribing practices and may capture differential effectiveness associated with the intervention not captured by repeat self-harm and survival.</p><p>The committee agreed that quality of life, service user satisfaction, concordance/ adherence/ compliance and financial impact were important outcomes. Quality of life was chosen as an important outcome as this is a global measure of well-being and may capture aspects of effectiveness of the interventions not captured by any of the other outcome measures. The committee recognised that some prescribing practices may be associated with a higher financial burden than others due to the potential for more frequent prescription charges, and service user satisfaction and financial impact were therefore chosen as important outcomes as both may influence whether the patient adheres to the prescription as recommended. Concordance/ adherence/ compliance was chosen as an important outcome which can directly capture whether the patient adhered to the prescription as recommended as it is also an indicator of the acceptability and success of the intervention.</p></div><div id="bcms6510.s1.1.10.2"><h5>The quality of the evidence</h5><p>No studies were identified that met the inclusion criteria so the committee based the recommendations on their own knowledge and experience.</p><p>Despite the lack of evidence, the committee decided not to prioritise this topic for research recommendations because the general issue of the relative toxicity of drugs and their potential use for self-harm or suicide is not specific to people who have self-harmed, but is a wider issue for people receiving both mental and physical healthcare. Therefore, the population for any study on safe prescribing should not realistically be contained to people who have self-harmed. Additionally, the committee agreed that any new evidence would be unlikely to change recommendations, which were based on the committee’s knowledge and experience of current best practice.</p></div><div id="bcms6510.s1.1.10.3"><h5>Benefits and harms</h5><p>The committee agreed that when prescribing medication to people following an episode of self-harm using any method, it is important to take into account the toxicity of the prescribed medications, particularly for people who have self-poisoned. Based on their knowledge and experience, the committee highlighted the particular risk of opiate-containing painkillers and tricyclic antidepressants with regards to fatal overdoses, but agreed there were a number of medications which could cause significant harm through overdose. It is also important to assess the person’s drug and alcohol consumption because concurrent use can increase the toxicity associated with some medications. The committee agreed the prescriber should also take into account the person’s wider access to medications when prescribing to reduce rates of self-poisoning. This decision was based on their knowledge that people can self-poison using medications bought online, prescribed for unrelated conditions, or prescribed to people who they live with or are close to. The committee discussed the ethics and feasibility of obtaining information about the person’s wider access to medication and agreed that it should be discussed with the person or assessed through medical records. Based on their experience that communication can sometimes be lacking between professionals when multiple prescribers are involved in a person’s care, the committee agreed that effective communication between prescribers is important to ensure all relevant professionals are kept up-to-date regarding any prescribing decisions made. The committee also referred to NICE’s existing guidance on <a href="https://www.nice.org.uk/guidance/ng105" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Preventing suicide in community and custodial settings (NG105)</a> when making these recommendations.</p><p>The committee identified that a key component of safer prescribing was limiting the quantity of medications prescribed to people with a history of self-harm. The committee discussed the importance of shared decision-making when deciding on the quantity of medications to prescribe as this may have financial implications for the person, which affect adherence and service user satisfaction, and they referred to the NICE guidance on <a href="https://www.nice.org.uk/guidance/ng197" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Shared decision making (NG197)</a>. The committee agreed that the prescriber should find an appropriate solution that prioritised the person’s safety while promoting adherence to medication, and that the prescriber should encourage the person to return any unwanted medicines for safe disposal.</p><p>The committee agreed, based on their experience, that this would reduce rates of self-poisoning.</p><p>The committee agreed that all existing and any new medications prescribed should be reviewed following an episode of self-harm and any repeat episodes. The committee discussed that this was important to ensure that any new prescriptions took into account toxicity associated with concurrent use of medicines, as they may not have specialist knowledge on the pharmacokinetic properties of medicines. If necessary, prescribers should contact a local medicines information centre through the UK Medicines Information service. The committee also referred to the NICE guidance on <a href="https://www.nice.org.uk/guidance/ng5" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Medicines optimisation (NG5)</a> and the <a href="https://www.england.nhs.uk/learning-disabilities/improving-health/stamp/" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">STOMP-STAMP principles</a> for information regarding prescribing for people with learning disabilities, autism, or both.</p><p>The committee highlighted that the role of community pharmacy staff in relation to self-harm was identifying people who may be purchasing medication with the intent of self-poisoning, and using their position as community-placed healthcare staff to discuss intent with people who might self-harm. They agreed based on experience that this was usually indicated when people were in acute distress or purchasing large quantities of medicines over the counter, and that pharmacy staff should be aware of these warning signs so they can respond appropriately. The committee agreed that such a response should include consultations and medicines reviews whereby pharmacy staff can discuss self-harm with people as appropriate and enact safe prescribing principles, such as using shared decision-making to limit the quantity of medicines supplied to the person. Consultations would also give staff the opportunity to provide support to people who they might already have an established relationship with, especially pharmacists who work in the community and regularly interact with the same people. The committee pointed out that other healthcare professionals, including GPs, should also use consultations and medicines reviews as an opportunity to assess how self-harm may interact with substances that could be taken in overdose, particularly when prescribing new medications. The committee discussed the harms and benefits of this approach, and agreed that while this may have the inadvertent outcome of some people being inaccurately identified as intending to self-harm, the benefits of correctly identifying when an individual is intending to self-harm and responding appropriately include the prevention of self-poisoning or overdose.</p><p>Despite the lack of evidence, the committee did not choose to make any research recommendations for safer prescribing. The committee agreed that existing NICE guidelines on safe prescribing are relevant for people who self-harm and there is no need to make recommendations specifically for people who self-harm further to those made in this guideline.</p></div><div id="bcms6510.s1.1.10.4"><h5>Cost effectiveness and resource use</h5><p>The committee noted that no relevant published economic evaluations had been identified and no additional economic analysis had been undertaken in this area. They drafted recommendations aimed to promote changes in service delivery and to reduce variation across the NHS in delivering safe prescribing for people who have self-harmed. The committee based such recommendations on the evidence and on existing NICE guidance. They expressed the view that for prescribers, these recommendations may mean that they review current prescriptions more routinely after an episode of self-harm with respect to the person’s risks of toxicity from overdose. For primary healthcare professionals, these recommendations may increase communication with healthcare professionals from other settings, such as specialist mental health centres and specialist pharmacies when prescribing and reviewing medications. Improved communication between healthcare professionals should limit variations in prescribing practices and improve continuity of care. The committee expressed the opinion that potential changes in current practice should not result in a significant resource impact.</p><p>The committee expressed the view that any resource implications associated with medicine reviews following an episode of self-harm would ensure the person’s safety and would therefore be outweighed by benefits.</p></div></div><div id="bcms6510.s1.1.11"><h4>Recommendations supported by this evidence review</h4><p>This evidence review supports recommendations 1.13.1-1.13.5.</p></div></div><div id="bcms6510.s1.rl.r1"><h3>References – included studies</h3><ul class="simple-list"><div id="bcms6510.s1.rl.r1.1"><h4>Effectiveness</h4><ul class="simple-list"><p>No studies were identified that met the inclusion criteria.</p></ul></div><div id="bcms6510.s1.rl.r1.2"><h4>Economic</h4><ul class="simple-list"><p>No studies were identified that met the inclusion criteria.</p></ul></div></ul></div></div><div id="appendixesappgroup1"><h2 id="_appendixesappgroup1_">Appendices</h2><div id="bcms6510.appa"><h3>Appendix A. Review protocols</h3><p id="bcms6510.appa.et1"><a href="/books/NBK588195/bin/bcms6510-appa-et1.pdf" class="bk_dwnld_icn bk_dwnld_pdf">Review protocol for review question: What are the key principles of safer prescribing for people who have self-harmed?</a><span class="small"> (PDF, 193K)</span></p></div><div id="bcms6510.appb"><h3>Appendix B. Literature search strategies</h3><p id="bcms6510.appb.et1"><a href="/books/NBK588195/bin/bcms6510-appb-et1.pdf" class="bk_dwnld_icn bk_dwnld_pdf">Literature search strategies for review question: What are the key principles of safer prescribing for people who have self-harmed?</a><span class="small"> (PDF, 440K)</span></p></div><div id="bcms6510.appc"><h3>Appendix C. Effectiveness evidence study selection</h3><p id="bcms6510.appc.et1"><a href="/books/NBK588195/bin/bcms6510-appc-et1.pdf" class="bk_dwnld_icn bk_dwnld_pdf">Study selection for review question: What are the key principles of safer prescribing for people who have self-harmed?</a><span class="small"> (PDF, 190K)</span></p></div><div id="bcms6510.appd"><h3>Appendix D. Evidence tables</h3><div id="bcms6510.appd.s1"><h4>Evidence tables for review question: What are the key principles of safer prescribing for people who have self-harmed?</h4><p>No evidence was identified which was applicable to this review question.</p></div></div><div id="bcms6510.appe"><h3>Appendix E. Forest plots</h3><div id="bcms6510.appe.s1"><h4>Forest plots for review question: What are the key principles of safer prescribing for people who have self-harmed?</h4><p>No meta-analysis was conducted for this review question and so there are no forest plots.</p></div></div><div id="bcms6510.appf"><h3>Appendix F. Modified GRADE tables</h3><div id="bcms6510.appf.s1"><h4>Modified GRADE tables for review question: What are the key principles of safer prescribing for people who have self-harmed?</h4><p>No evidence was identified which was applicable to this review question.</p></div></div><div id="bcms6510.appg"><h3>Appendix G. Economic evidence study selection</h3><p id="bcms6510.appg.et1"><a href="/books/NBK588195/bin/bcms6510-appg-et1.pdf" class="bk_dwnld_icn bk_dwnld_pdf">Study selection for review question: What are the key principles of safer prescribing for people who have self-harmed?</a><span class="small"> (PDF, 150K)</span></p></div><div id="bcms6510.apph"><h3>Appendix H. Economic evidence tables</h3><div id="bcms6510.apph.s1"><h4>Economic evidence tables for review question: What are the key principles of safer prescribing for people who have self-harmed?</h4><p>No evidence was identified which was applicable to this review question.</p></div></div><div id="bcms6510.appi"><h3>Appendix I. Economic model</h3><div id="bcms6510.appi.s1"><h4>Economic model for review question: What are the key principles of safer prescribing for people who have self-harmed?</h4><p>No economic analysis was conducted for this review question.</p></div></div><div id="bcms6510.appj"><h3>Appendix J. Excluded studies</h3><div id="bcms6510.appj.s1"><h4>Excluded studies for review question: What are the key principles of safer prescribing for people who have self-harmed?</h4></div><div id="bcms6510.appj.s2"><h4>Excluded effectiveness studies</h4><p id="bcms6510.appj.tab1"><a href="/books/NBK588195/table/bcms6510.appj.tab1/?report=objectonly" target="object" rid-ob="figobbcms6510appjtab1" class="figpopup">Table 3. Excluded studies and reasons for their exclusion</a></p></div><div id="bcms6510.appj.s3"><h4>Excluded economic studies</h4><p id="bcms6510.appj.tab2"><a href="/books/NBK588195/table/bcms6510.appj.tab2/?report=objectonly" target="object" rid-ob="figobbcms6510appjtab2" class="figpopup">Table 4. Excluded studies from the guideline economic review</a></p></div></div><div id="bcms6510.appk"><h3>Appendix K. Research recommendations – full details</h3><div id="bcms6510.appk.s1"><h4>Research recommendations for review question: What are the key principles of safer prescribing for people who have self-harmed?</h4><p>No research recommendations were made for this review question.</p></div></div></div></div><div class="fm-sec"><div><p>Final</p></div><div><p>Evidence reviews underpinning recommendations 1.13.1 to 1.13.5 in the NICE guideline</p></div><div><p><b>Disclaimer</b>: The recommendations in this guideline represent the view of NICE, arrived at after careful consideration of the evidence available. When exercising their judgement, professionals are expected to take this guideline fully into account, alongside the individual needs, preferences and values of their patients or service users. The recommendations in this guideline are not mandatory and the guideline does not override the responsibility of healthcare professionals to make decisions appropriate to the circumstances of the individual patient, in consultation with the patient and/or their carer or guardian.</p><p>Local commissioners and/or providers have a responsibility to enable the guideline to be applied when individual health professionals and their patients or service users wish to use it. They should do so in the context of local and national priorities for funding and developing services, and in light of their duties to have due regard to the need to eliminate unlawful discrimination, to advance equality of opportunity and to reduce health inequalities. Nothing in this guideline should be interpreted in a way that would be inconsistent with compliance with those duties.</p><p>NICE guidelines cover health and care in England. Decisions on how they apply in other UK countries are made by ministers in the <a href="http://wales.gov.uk/" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Welsh Government</a>, <a href="http://www.scotland.gov.uk/" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Scottish Government</a>, and <a href="http://www.northernireland.gov.uk/" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Northern Ireland Executive</a>. All NICE guidance is subject to regular review and may be updated or withdrawn.</p></div><div class="half_rhythm"><a href="/books/about/copyright/">Copyright</a> © NICE 2022.</div><div class="small"><span class="label">Bookshelf ID: NBK588195</span><span class="label">PMID: <a href="https://pubmed.ncbi.nlm.nih.gov/36595607" title="PubMed record of this title" ref="pagearea=meta&targetsite=entrez&targetcat=link&targettype=pubmed">36595607</a></span></div></div><div class="small-screen-prev"></div><div class="small-screen-next"></div></article><article data-type="table-wrap" id="figobbcms6510tab1"><div id="bcms6510.tab1" class="table"><h3><span class="label">Table 1</span><span class="title">Summary of the protocol (PICO table)</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK588195/table/bcms6510.tab1/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__bcms6510.tab1_lrgtbl__"><table><tbody><tr><th id="hd_b_bcms6510.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Population</th><td headers="hd_b_bcms6510.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">
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<p>
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<b>Inclusion:</b>
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</p>
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<p>All people who have self-harmed, including those with a mental health problem, neurodevelopmental disorder or a learning disability.</p>
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<p>
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<b>Exclusion:</b>
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</p>
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<p>People displaying repetitive stereotypical self-injurious behaviour, for example head-banging in people with a significant learning disability</p>
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</td></tr><tr><th id="hd_b_bcms6510.tab1_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Intervention</th><td headers="hd_b_bcms6510.tab1_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Any specific approach to safer prescribing for people who have self-harmed (enhanced safer prescribing), for example, choosing safer medications (that is, those with a lower toxicity index), or limiting the prescription size to reduce availability</td></tr><tr><th id="hd_b_bcms6510.tab1_1_1_3_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Comparison</th><td headers="hd_b_bcms6510.tab1_1_1_3_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Treatment as usual employing the standard level of safer prescribing for people who have self-harmed (that is, taking into account the characteristics of the person for whom the prescription is for)</td></tr><tr><th id="hd_b_bcms6510.tab1_1_1_4_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Outcome</th><td headers="hd_b_bcms6510.tab1_1_1_4_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"><b>Critical</b>
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<ul><li class="half_rhythm"><div>Self-harm repetition (for example, self-poisoning or self-cutting)</div></li><li class="half_rhythm"><div>Suicide</div></li><li class="half_rhythm"><div>Adverse event of prescribed drug</div></li></ul>
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<b>Important</b>
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<ul><li class="half_rhythm"><div>Quality of life</div></li><li class="half_rhythm"><div>Service user satisfaction</div></li><li class="half_rhythm"><div>Concordance/adherence/compliance with drugs as prescribed</div></li><li class="half_rhythm"><div>Financial impact</div></li></ul></td></tr></tbody></table></div></div></article><article data-type="table-wrap" id="figobbcms6510appjtab1"><div id="bcms6510.appj.tab1" class="table"><h3><span class="label">Table 3</span><span class="title">Excluded studies and reasons for their exclusion</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK588195/table/bcms6510.appj.tab1/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__bcms6510.appj.tab1_lrgtbl__"><table><thead><tr><th id="hd_h_bcms6510.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Study</th><th id="hd_h_bcms6510.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Code [Reason]</th></tr></thead><tbody><tr><td headers="hd_h_bcms6510.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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Chew-Graham, C. A., Morgan, C., Webb, R. T.
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et al. (2019) Reducing risk following self-harm: The need for careful prescribing. British Journal of General Practice
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69: 224–225 [<a href="/pmc/articles/PMC6478455/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC6478455</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/31023669" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 31023669</span></a>]
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</td><td headers="hd_h_bcms6510.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">- Narrative review</td></tr><tr><td headers="hd_h_bcms6510.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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Cleary, E., Kelleher, C. C., Lane, A.
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et al. (2020) Limiting psychotropic medication prescription on discharge from psychiatric inpatient care: A possible suicide intervention?. Irish Journal of Psychological Medicine
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37: 43–47 [<a href="https://pubmed.ncbi.nlm.nih.gov/31182176" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 31182176</span></a>]
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</td><td headers="hd_h_bcms6510.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">- Non-comparative study</td></tr><tr><td headers="hd_h_bcms6510.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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Dyer, O. (2007) Teen suicide rate rises as prescribing of SSRIs falls, study finds. BMJ (Clinical research ed.)
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335: 531 [<a href="/pmc/articles/PMC1976535/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC1976535</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/17855299" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 17855299</span></a>]
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</td><td headers="hd_h_bcms6510.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">- Narrative review</td></tr><tr><td headers="hd_h_bcms6510.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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Fernandes, V. and Flak, E. (2012) Safe and effective prescribing practices at the point of discharge from an inpatient psychiatry unit. Journal of Psychiatric Practice
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18: 12–19 [<a href="https://pubmed.ncbi.nlm.nih.gov/22261979" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 22261979</span></a>]
|
|
</td><td headers="hd_h_bcms6510.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">- Narrative review</td></tr><tr><td headers="hd_h_bcms6510.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Freeman, S. A. (2009) Suicide risk and psychopharmacology: assessment and management of acute and chronic risk factors. Journal of Clinical Psychiatry
|
|
70: 1052–3 [<a href="https://pubmed.ncbi.nlm.nih.gov/19653981" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 19653981</span></a>]
|
|
</td><td headers="hd_h_bcms6510.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">- Narrative review</td></tr><tr><td headers="hd_h_bcms6510.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Gjelsvik, B., Heyerdah, F., Lunn, D.
|
|
et al. (2014) Change in access to prescribed medication following an episode of deliberate self-poisoning: A multilevel approach. PLoS ONE
|
|
9 (5) [<a href="/pmc/articles/PMC4031187/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC4031187</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/24854351" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 24854351</span></a>]
|
|
</td><td headers="hd_h_bcms6510.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>- Comparison not in PICO</p>
|
|
<p>Interventions/comparison not in PICO: No comparison of different prescribing practices (study compares drugs prescribed to a sample of patients before and after an index episode of deliberate self-poisoning)</p>
|
|
</td></tr><tr><td headers="hd_h_bcms6510.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Gjelsvik, B.; Heyerdahl, F.; Hawton, K. (2012) Prescribed medication availability and deliberate self-poisoning: A longitudinal study. Journal of Clinical Psychiatry
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|
73: e548–e554 [<a href="https://pubmed.ncbi.nlm.nih.gov/22579161" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 22579161</span></a>]
|
|
</td><td headers="hd_h_bcms6510.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>- Comparison not in PICO</p>
|
|
<p>No comparison of different prescribing practices (study compares patients v general population in prescribed drugs and doses)</p>
|
|
</td></tr><tr><td headers="hd_h_bcms6510.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Healy, D. (2009) Are selective serotonin reuptake inhibitors a risk factor for adolescent suicide?. Canadian Journal of Psychiatry
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|
54: 69–71 [<a href="https://pubmed.ncbi.nlm.nih.gov/19254434" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 19254434</span></a>]
|
|
</td><td headers="hd_h_bcms6510.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">- Narrative review</td></tr><tr><td headers="hd_h_bcms6510.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Kapur, N., Steeg, S., Webb, R.
|
|
et al. (2013) Does Clinical Management Improve Outcomes following Self-Harm? Results from the Multicentre Study of Self-Harm in England. PLoS ONE
|
|
8 (8) [<a href="/pmc/articles/PMC3731259/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC3731259</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/23936430" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 23936430</span></a>]
|
|
</td><td headers="hd_h_bcms6510.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>- Intervention not in PICO</p>
|
|
<p>No prescribing practices</p>
|
|
</td></tr><tr><td headers="hd_h_bcms6510.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
King, J.; Cabarkapa, S.; Leow, F. (2019) Adolescent self-harm: Think before prescribing. Australian Prescriber
|
|
42: 90–92 [<a href="/pmc/articles/PMC6594847/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC6594847</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/31363306" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 31363306</span></a>]
|
|
</td><td headers="hd_h_bcms6510.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">- Narrative review</td></tr><tr><td headers="hd_h_bcms6510.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Morgan, C., Webb, R. T., Carr, M. J.
|
|
et al. (2018) Self-harm in a primary care cohort of older people: incidence, clinical management, and risk of suicide and other causes of death. The Lancet Psychiatry
|
|
5: 905–912 [<a href="/pmc/articles/PMC6203699/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC6203699</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/30337211" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 30337211</span></a>]
|
|
</td><td headers="hd_h_bcms6510.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>- Intervention not in PICO</p>
|
|
<p>Observational study examining prescribing patterns of drugs after self-harm, but safe prescribing practices not examined and not associated with PICO outcomes; suggestions for ‘alternative’ prescribing made based on findings</p>
|
|
</td></tr><tr><td headers="hd_h_bcms6510.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Morgan, C., Webb, R. T., Carr, M. J.
|
|
et al. (2017) Incidence, clinical management, and mortality risk following self harm among children and adolescents: Cohort study in primary care. BMJ (Online)
|
|
359 (no pagination) [<a href="/pmc/articles/PMC5641980/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC5641980</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/29046278" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 29046278</span></a>]
|
|
</td><td headers="hd_h_bcms6510.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>- Intervention not in PICO</p>
|
|
<p>Observational study; clinical management patterns described by drug, not by prescribing practices and not associated with outcomes of interest</p>
|
|
</td></tr><tr><td headers="hd_h_bcms6510.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
O’Malley, P. A. (2018) A Season of Self-destruction-The Current Suicide Epidemic in Older Adults: Evidence to Consider Before Writing the Prescription. Clinical nurse specialist CNS
|
|
32: 290–293 [<a href="https://pubmed.ncbi.nlm.nih.gov/30299329" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 30299329</span></a>]
|
|
</td><td headers="hd_h_bcms6510.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">- Narrative review</td></tr><tr><td headers="hd_h_bcms6510.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Rashid, A. (2016) Yonder: Self-harm, repeat prescribing, deprescribing, and worry. British Journal of General Practice
|
|
66: 261 [<a href="/pmc/articles/PMC4838432/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC4838432</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/27127282" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 27127282</span></a>]
|
|
</td><td headers="hd_h_bcms6510.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">- Narrative review</td></tr><tr><td headers="hd_h_bcms6510.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Tote, S. and Mulleague, L. (2005) The role of flumazenil in self harm with benzodiazepines: To give or not to give?. Hospital Medicine
|
|
66: 308 [<a href="https://pubmed.ncbi.nlm.nih.gov/15920864" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 15920864</span></a>]
|
|
</td><td headers="hd_h_bcms6510.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">- Narrative review</td></tr><tr><td headers="hd_h_bcms6510.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Windfuhr, K., While, D., Kapur, N.
|
|
et al. (2016) Suicide risk linked with clinical consultation frequency, psychiatric diagnoses and psychotropic medication prescribing in a national study of primary-care patients. Psychological medicine
|
|
46: 3407–3417 [<a href="https://pubmed.ncbi.nlm.nih.gov/27650367" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 27650367</span></a>]
|
|
</td><td headers="hd_h_bcms6510.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>- Comparison not in PICO</p>
|
|
<p>No comparison of different prescribing practices</p>
|
|
</td></tr></tbody></table></div></div></article><article data-type="table-wrap" id="figobbcms6510appjtab2"><div id="bcms6510.appj.tab2" class="table"><h3><span class="label">Table 4</span><span class="title">Excluded studies from the guideline economic review</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK588195/table/bcms6510.appj.tab2/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__bcms6510.appj.tab2_lrgtbl__"><table><thead><tr><th id="hd_h_bcms6510.appj.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Study</th><th id="hd_h_bcms6510.appj.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Reason for Exclusion</th></tr></thead><tbody><tr><td headers="hd_h_bcms6510.appj.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Adrian, M., Lyon, A. R., Nicodimos, S., Pullmann, M. D., McCauley, E., Enhanced “Train and Hope” for Scalable, Cost-Effective Professional Development in Youth Suicide Prevention, Crisis, 39, 235–246, 2018 [<a href="https://pubmed.ncbi.nlm.nih.gov/29183240" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 29183240</span></a>]
|
|
</td><td headers="hd_h_bcms6510.appj.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Not relevant to any of the review questions in the guideline - this study examined the impact of an educational training ongoing intervention, and the effect of the post-training reminder system, on mental health practitioners’ knowledge, attitudes, and behaviour surrounding suicide assessment and intervention. As well, this study was not a full health economic evaluation</td></tr><tr><td headers="hd_h_bcms6510.appj.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Borschmann
|
|
R, Barrett
|
|
B, Hellier
|
|
JM, et al. Joint crisis plans for people with borderline personality disorder: feasibility and outcomes in a randomised controlled trial. Br J Psychiatry. 2013;202(5):357–364. [<a href="https://pubmed.ncbi.nlm.nih.gov/23637110" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 23637110</span></a>]
|
|
</td><td headers="hd_h_bcms6510.appj.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Not relevant to any of the review questions in the guideline - this study examined the feasibility of recruiting and retaining adults with borderline personality disorder to a pilot randomised controlled trial investigating the potential efficacy and cost-effectiveness of using a joint crisis plan</td></tr><tr><td headers="hd_h_bcms6510.appj.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Bustamante Madsen, L., Eddleston, M., Schultz Hansen, K., Konradsen, F., Quality Assessment of Economic Evaluations of Suicide and Self-Harm Interventions, Crisis, 39, 82–95, 2018 [<a href="https://pubmed.ncbi.nlm.nih.gov/28914094" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 28914094</span></a>]
|
|
</td><td headers="hd_h_bcms6510.appj.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Study design - this review of health economics studies has been excluded for this guideline, but its references have been hand-searched for any relevant health economic study</td></tr><tr><td headers="hd_h_bcms6510.appj.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Byford, S., Barrett, B., Aglan, A., Harrington, V., Burroughs, H., Kerfoot, M., Harrington, R. C., Lifetime and current costs of supporting young adults who deliberately poisoned themselves in childhood and adolescence, Journal of Mental Health, 18, 297–306, 2009
|
|
</td><td headers="hd_h_bcms6510.appj.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Study design – no comparative cost analysis</td></tr><tr><td headers="hd_h_bcms6510.appj.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Byford, S., Leese, M., Knapp, M., Seivewright, H., Cameron, S., Jones, V., Davidson, K., Tyrer, P., Comparison of alternative methods of collection of service use data for the economic evaluation health care interventions, Health Economics, 16, 531–536, 2007 [<a href="https://pubmed.ncbi.nlm.nih.gov/17001749" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 17001749</span></a>]
|
|
</td><td headers="hd_h_bcms6510.appj.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Study design – no comparative cost analysis</td></tr><tr><td headers="hd_h_bcms6510.appj.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Byford, Sarah, Barber, Julie A., Harrington, Richard, Barber, Baruch Beautrais Blough Brent Brodie Byford Carlson Chernoff Collett Fergusson Garland Goldberg Harman Harrington Hawton Huber Kazdin Kazdin Kerfoot Kerfoot Kerfoot Knapp Lindsey McCullagh Miller Netten Reynolds Sadowski Shaffer Simms Wu, Factors that influence the cost of deliberate self-poisoning in children and adolescents, Journal of Mental Health Policy and Economics, 4, 113–121, 2001 [<a href="https://pubmed.ncbi.nlm.nih.gov/11967471" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 11967471</span></a>]
|
|
</td><td headers="hd_h_bcms6510.appj.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Study design – no comparative cost analysis</td></tr><tr><td headers="hd_h_bcms6510.appj.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Denchev, P., Pearson, J. L., Allen, M. H., Claassen, C. A., Currier, G. W., Zatzick, D. F., Schoenbaum, M., Modeling the cost-effectiveness of interventions to reduce suicide risk among hospital emergency department patients, Psychiatric Services, 69, 23–31, 2018 [<a href="/pmc/articles/PMC5750130/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC5750130</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/28945181" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 28945181</span></a>]
|
|
</td><td headers="hd_h_bcms6510.appj.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Not relevant to any of the review questions in the guideline - this study estimated the cost-effectiveness of outpatient interventions (Postcards, Telephone outreach, Cognitive Behaviour Therapy) to reduce suicide risk among patients presenting to general hospital emergency departments</td></tr><tr><td headers="hd_h_bcms6510.appj.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Dunlap, L. J., Orme, S., Zarkin, G. A., Arias, S. A., Miller, I. W., Camargo, C. A., Sullivan, A. F., Allen, M. H., Goldstein, A. B., Manton, A. P., Clark, R., Boudreaux, E. D., Screening and Intervention for Suicide Prevention: A Cost-Effectiveness Analysis of the ED-SAFE Interventions, Psychiatric services (Washington, D.C.), appips201800445, 2019 [<a href="https://pubmed.ncbi.nlm.nih.gov/31451063" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 31451063</span></a>]
|
|
</td><td headers="hd_h_bcms6510.appj.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Not relevant to any of the review questions in the guideline - this study estimated the cost-effectiveness of suicide screening followed by an intervention to identify suicidal individuals and prevent recurring self-harm</td></tr><tr><td headers="hd_h_bcms6510.appj.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Fernando, S. M., Reardon, P. M., Ball, I. M., van Katwyk, S., Thavorn, K., Tanuseputro, P., Rosenberg, E., Kyeremanteng, K., Outcomes and Costs of Patients Admitted to the Intensive Care Unit Due to Accidental or Intentional Poisoning, Journal of Intensive Care Medicine, 35, 386–393, 2020 [<a href="https://pubmed.ncbi.nlm.nih.gov/29357777" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 29357777</span></a>]
|
|
</td><td headers="hd_h_bcms6510.appj.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Study design – no comparative cost analysis</td></tr><tr><td headers="hd_h_bcms6510.appj.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Flood, C., Bowers, L., Parkin, D., Estimating the costs of conflict and containment on adult acute inpatient psychiatric wards, Nursing economic$, 26, 325–330, 324, 2008 [<a href="https://pubmed.ncbi.nlm.nih.gov/18979699" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 18979699</span></a>]
|
|
</td><td headers="hd_h_bcms6510.appj.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Study design – no comparative cost analysis</td></tr><tr><td headers="hd_h_bcms6510.appj.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Fortune, Z., Barrett, B., Armstrong, D., Coid, J., Crawford, M., Mudd, D., Rose, D., Slade, M., Spence, R., Tyrer, P., Moran, P., Clinical and economic outcomes from the UK pilot psychiatric services for personality-disordered offenders, International Review of Psychiatry, 23, 61–9, 2011 [<a href="https://pubmed.ncbi.nlm.nih.gov/21338300" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 21338300</span></a>]
|
|
</td><td headers="hd_h_bcms6510.appj.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Not relevant to any of the review questions in the guideline</td></tr><tr><td headers="hd_h_bcms6510.appj.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
George, S., Javed, M., Hemington-Gorse, S., Wilson-Jones, N., Epidemiology and financial implications of self-inflicted burns, Burns, 42, 196–201, 2016 [<a href="https://pubmed.ncbi.nlm.nih.gov/26670160" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 26670160</span></a>]
|
|
</td><td headers="hd_h_bcms6510.appj.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Study design – no comparative cost analysis</td></tr><tr><td headers="hd_h_bcms6510.appj.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Gunnell, D., Shepherd, M., Evans, M., Are recent increases in deliberate self-harm associated with changes in socio-economic conditions? An ecological analysis of patterns of deliberate self-harm in Bristol 1972-3 and 1995-6, Psychological medicine, 30, 1197–1203, 2000 [<a href="https://pubmed.ncbi.nlm.nih.gov/12027054" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 12027054</span></a>]
|
|
</td><td headers="hd_h_bcms6510.appj.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Study design - cost-of-illness study</td></tr><tr><td headers="hd_h_bcms6510.appj.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Kapur, N., House, A., Dodgson, K., Chris, M., Marshall, S., Tomenson, B., Creed, F., Management and costs of deliberate self-poisoning in the general hospital: A multi-centre study, Journal of Mental Health, 11, 223–230, 2002
|
|
</td><td headers="hd_h_bcms6510.appj.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Study design – no comparative cost analysis</td></tr><tr><td headers="hd_h_bcms6510.appj.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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Kapur, N., House, A., May, C., Creed, F., Service provision and outcome for deliberate self-poisoning in adults - Results from a six centre descriptive study, Social Psychiatry and Psychiatric Epidemiology, 38, 390–395, 2003 [<a href="https://pubmed.ncbi.nlm.nih.gov/12861446" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 12861446</span></a>]
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</td><td headers="hd_h_bcms6510.appj.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Study design – no comparative cost analysis</td></tr><tr><td headers="hd_h_bcms6510.appj.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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Kinchin, I., Russell, A. M. T., Byrnes, J., McCalman, J., Doran, C. M., Hunter, E., The cost of hospitalisation for youth self-harm: differences across age groups, sex, Indigenous and non-Indigenous populations, Social Psychiatry and Psychiatric Epidemiology, 55, 425–434, 2020 [<a href="https://pubmed.ncbi.nlm.nih.gov/31732765" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 31732765</span></a>]
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</td><td headers="hd_h_bcms6510.appj.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Study design – no comparative cost analysis</td></tr><tr><td headers="hd_h_bcms6510.appj.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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O’Leary, F. M., Lo, M. C. I., Schreuder, F. B., “Cuts are costly”: A review of deliberate self-harm admissions to a district general hospital plastic surgery department over a 12-month period, Journal of Plastic, Reconstructive and Aesthetic Surgery, 67, e109–e110, 2014 [<a href="https://pubmed.ncbi.nlm.nih.gov/24183058" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 24183058</span></a>]
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</td><td headers="hd_h_bcms6510.appj.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Study design – no comparative cost analysis</td></tr><tr><td headers="hd_h_bcms6510.appj.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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Olfson, M., Gameroff, M. J., Marcus, S. C., Greenberg, T., Shaffer, D., National trends in hospitalization of youth with intentional self-inflicted injuries, American Journal of Psychiatry, 162, 1328–1335, 2005 [<a href="https://pubmed.ncbi.nlm.nih.gov/15994716" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 15994716</span></a>]
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</td><td headers="hd_h_bcms6510.appj.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Study design – no comparative cost analysis</td></tr><tr><td headers="hd_h_bcms6510.appj.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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Ostertag, L., Golay, P., Dorogi, Y., Brovelli, S., Cromec, I., Edan, A., Barbe, R., Saillant, S., Michaud, L., Self-harm in French-speaking Switzerland: A socio-economic analysis (7316), Swiss Archives of Neurology, Psychiatry and Psychotherapy, 70 (Supplement 8), 48S, 2019
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</td><td headers="hd_h_bcms6510.appj.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Conference abstract</td></tr><tr><td headers="hd_h_bcms6510.appj.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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Ougrin, D., Corrigall, R., Poole, J., Zundel, T., Sarhane, M., Slater, V., Stahl, D., Reavey, P., Byford, S., Heslin, M., Ivens, J., Crommelin, M., Abdulla, Z., Hayes, D., Middleton, K., Nnadi, B., Taylor, E., Comparison of effectiveness and cost-effectiveness of an intensive community supported discharge service versus treatment as usual for adolescents with psychiatric emergencies: a randomised controlled trial, The Lancet Psychiatry, 5, 477–485, 2018 [<a href="/pmc/articles/PMC5994473/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC5994473</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/29731412" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 29731412</span></a>]
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</td><td headers="hd_h_bcms6510.appj.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Not self-harm. In addition, the interventions evaluated in this economic analysis (a supported discharge service provided by an intensive community treatment team compared to usual care) were not relevant to any review questions</td></tr><tr><td headers="hd_h_bcms6510.appj.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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Palmer, S., Davidson, K., Tyrer, P., Gumley, A., Tata, P., Norrie, J., Murray, H., Seivewright, H., The cost-effectiveness of cognitive behavior therapy for borderline personality disorder: results from the BOSCOT trial, Journal of Personality Disorders, 20, 466–481, 2006 [<a href="/pmc/articles/PMC1852260/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC1852260</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/17032159" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 17032159</span></a>]
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</td><td headers="hd_h_bcms6510.appj.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Not self-harm</td></tr><tr><td headers="hd_h_bcms6510.appj.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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Quinlivan
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L, Steeg
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S, Elvidge
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J, et al. Risk assessment scales to predict risk of hospital treated repeat self-harm: A cost-effectiveness modelling analysis. J Affect Disord. 2019;249:208–215. [<a href="https://pubmed.ncbi.nlm.nih.gov/30772749" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 30772749</span></a>]
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</td><td headers="hd_h_bcms6510.appj.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Not relevant to any of the review questions in the guideline - this study estimated the cost-effectiveness of of risk assessment scales versus clinical assessment for adults attending an emergency department following self-harm</td></tr><tr><td headers="hd_h_bcms6510.appj.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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Richardson
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JS, Mark
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TL, McKeon
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R. The return on investment of postdischarge follow-up calls for suicidal ideation or deliberate self-harm. Psychiatr Serv. 2014;65(8):1012–1019. [<a href="https://pubmed.ncbi.nlm.nih.gov/24788454" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 24788454</span></a>]
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</td><td headers="hd_h_bcms6510.appj.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Not enough data reporting on cost-effectiveness findings</td></tr><tr><td headers="hd_h_bcms6510.appj.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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Smits, M. L., Feenstra, D. J., Eeren, H. V., Bales, D. L., Laurenssen, E. M. P., Blankers, M., Soons, M. B. J., Dekker, J. J. M., Lucas, Z., Verheul, R., Luyten, P., Day hospital versus intensive out-patient mentalisation-based treatment for borderline personality disorder: Multicentre randomised clinical trial, British Journal of Psychiatry, 216, 79–84, 2020 [<a href="https://pubmed.ncbi.nlm.nih.gov/30791963" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 30791963</span></a>]
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</td><td headers="hd_h_bcms6510.appj.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Not self-harm</td></tr><tr><td headers="hd_h_bcms6510.appj.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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Tsiachristas, A., Geulayov, G., Casey, D., Ness, J., Waters, K., Clements, C., Kapur, N., McDaid, D., Brand, F., Hawton, K., Incidence and general hospital costs of self-harm across England: estimates based on the multicentre study of self-harm, Epidemiology & Psychiatric Science, 29, e108, 2020 [<a href="/pmc/articles/PMC7214546/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC7214546</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/32160934" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 32160934</span></a>]
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</td><td headers="hd_h_bcms6510.appj.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Study design – no comparative cost analysis</td></tr><tr><td headers="hd_h_bcms6510.appj.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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Tsiachristas, A., McDaid, D., Casey, D., Brand, F., Leal, J., Park, A. L., Geulayov, G., Hawton, K., General hospital costs in England of medical and psychiatric care for patients who self-harm: a retrospective analysis, The Lancet Psychiatry, 4, 759–767, 2017 [<a href="/pmc/articles/PMC5614771/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC5614771</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/28890321" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 28890321</span></a>]
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</td><td headers="hd_h_bcms6510.appj.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Study design – no comparative cost analysis</td></tr><tr><td headers="hd_h_bcms6510.appj.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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Tubeuf, S., Saloniki, E. C., Cottrell, D., Parental Health Spillover in Cost-Effectiveness Analysis: Evidence from Self-Harming Adolescents in England, PharmacoEconomics, 37, 513–530, 2019 [<a href="https://pubmed.ncbi.nlm.nih.gov/30294758" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 30294758</span></a>]
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</td><td headers="hd_h_bcms6510.appj.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">This study is not a separate study from one already included in the guideline for topic 5.2 (Cottrel 2018). This secondary analysis presents alternative parental health spillover quantification methods in the context of a randomised controlled trial comparing family therapy with treatment as usual as an intervention for self-harming adolescents of (Cottrel 2018), and discusses the practical limitations of those methods</td></tr><tr><td headers="hd_h_bcms6510.appj.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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Tyrer, P., Thompson, S., Schmidt, U., Jones, V., Knapp, M., Davidson, K., Catalan, J., Airlie, J., Baxter, S., Byford, S., Byrne, G., Cameron, S., Caplan, R., Cooper, S., Ferguson, B., Freeman, C., Frost, S., Godley, J., Greenshields, J., Henderson, J., Holden, N., Keech, P., Kim, L., Logan, K., Manley, C., MacLeod, A., Murphy, R., Patience, L., Ramsay, L., De Munroz, S., Scott, J., Seivewright, H., Sivakumar, K., Tata, P., Thornton, S., Ukoumunne, O. C., Wessely, S., Randomized controlled trial of brief cognitive behaviour therapy versus treatment as usual in recurrent deliberate self-harm: The POPMACT study, Psychological medicine, 33, 969–976, 2003 [<a href="https://pubmed.ncbi.nlm.nih.gov/12946081" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 12946081</span></a>]
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</td><td headers="hd_h_bcms6510.appj.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Study design - no economic evaluation</td></tr><tr><td headers="hd_h_bcms6510.appj.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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Van Roijen, L. H., Sinnaeve, R., Bouwmans, C., Van Den Bosch, L., Cost-effectiveness and Cost-utility of Shortterm Inpatient Dialectical Behavior Therapy for Chronically Parasuicidal BPD (Young) Adults, Journal of Mental Health Policy and Economics, 18, S19–S20, 2015
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</td><td headers="hd_h_bcms6510.appj.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Conference abstract</td></tr><tr><td headers="hd_h_bcms6510.appj.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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van Spijker, B. A., Majo, M. C., Smit, F., van Straten, A., Kerkhof, A. J., Reducing suicidal ideation: cost-effectiveness analysis of a randomized controlled trial of unguided web-based self-help, Journal of medical Internet research, 14, e141, 2012 [<a href="/pmc/articles/PMC3517339/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC3517339</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/23103835" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 23103835</span></a>]
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</td><td headers="hd_h_bcms6510.appj.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Not self-harm</td></tr></tbody></table></div></div></article></div><div id="jr-scripts"><script src="/corehtml/pmc/jatsreader/ptpmc_3.22/js/libs.min.js"> </script><script src="/corehtml/pmc/jatsreader/ptpmc_3.22/js/jr.min.js"> </script></div></div>
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