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Postcards from the EDge: 24-month outcomes of a randomised controlled trial for hospital-treated self-poisoning

Suicide Prevention Research Unit, Centre for Mental Health Studies, Faculty of Health, University of Newcastle, New South Wales, and Department of Consultation-Liaison Psychiatry, Newcastle Mater Hospital, Newcastle

Kerrie Clover

Suicide Prevention Research Unit, Centre for Mental Health Studies, and Faculty of Health, University of Newcastle

Ian M. Whyte

Discipline of Clinical Pharmacology, Faculty of Health, University of Newcastle, and Department of Clinical Toxicology and Pharmacology, Newcastle Mater Hospital, Newcastle

Andrew H. Dawson

Discipline of Clinical Pharmacology, Faculty of Health, University of Newcastle, Australia, and South Asian Clinical Toxicology Research Collaboration University of Peradeniya, Sri Lanka

Catherine D'Este

Centre for Clinical Epidemiology and Biostatistics, Faculty of Health, University of Newcastle, and Centre for Military and Veterans' Health, University of Queensland, Brisbane, Australia

Correspondence: Dr Gregory Carter, Department of Consultation-Liaison Psychiatry, Locked Bag 7, Hunter Region Mail Centre, NSW 2310, Australia. Tel: + 61 2 4921 1283; fax: + 61 2 4921 1870; email: Gregory.Carter{at}newcastle.edu.au

Declaration of interest None.

Background Repetition of self-poisoning is common.

Aims To report the 24-month outcomes of a non-obligatory postcard intervention (plus treatment as usual) compared with treatment as usual.

Method In a randomised-controlled trial (Zelen design) conducted in Newcastle, Australia, eight postcards were sent to participants over a 12-month period. The principal outcomes were the proportion of participants with one or more repeat episodes of self-poisoning and the number of repeat episodes per person.

Results No significant reduction was observed in the proportion of people repeating self-poisoning in the intervention group (21.2%, 95% CI 17.0-25.3) compared with the control group (22.8%, 95% CI 18.7-27.0; ²=0.32, d.f.=1, P=0.57); the difference between groups was –1.7% (95% CI –7.5 to 4.2). There was a significant reduction in the rate of repetition, with an incidence risk ratio of 0.49 (95% CI 0.33-0.73).

Conclusions A postcard intervention maintained the halving of the rate of repetition of hospital-treated self-poisoning events over a 2-year period, although it did not significantly reduce the proportion of individuals who repeated self-poisoning.

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