New Intervention Program Reduces Re-Admission Rate for Patients with Co-Morbid Depression

The Bottom Line

Project RED-D, a 12-week post discharge intervention program, results in fewer re-admissions in Boston Medical Center patients with co-morbid depression and depressive symptoms. 

Context

When Project RED was first established by BMC researchers in 2007, the team outlined a set of strategies aimed at improving the patient discharge process. At the time, the goal was to reduce rates of readmission post-discharge and maintain patient health and recovery post-discharge. Patients were provided with easy-to-read, color-coded plan with information on medication, upcoming appointments, and a calendar of activities for the upcoming 30 days, keeping patients informed and in touch with their own recovery.

The Project RED team began to notice that patients hospitalized with co-morbid depression symptoms were readmitted to the hospital and utilizing the emergency department at rates 1.5 to 2 times higher than their counterparts without symptoms of depression. Depression is a significant risk factor for poor outcomes among patients with acute and chronic conditions. For people of color, the risk of depression is higher than their white counterparts.  

Published in Annals of Family Medicine, researchers discovered a 70 and 48 percent reduction in hospital re-admittance at the 30- and 90-day mark following post-discharge care by an adapted version of the Re-Engineered Discharge (RED) Program, a nationally disseminated readmission reduction program, among adherents to the program. The adapted version is named RED for Depression (RED-D).

Study Objective

To determine if hospitalized patients with co-morbid depression could benefit from a post-discharge depression treatment intervention.

The Details

The researchers conducted a randomized control trial that included 709 participants to evaluate the RED-D program. Each participant was randomly selected to either receive the RED or the RED-D intervention. As a 12-week discharge program, Project RED-D includes new protocols and treatment methods for those with depression and depressive symptoms. The intervention provides telephonic brief cognitive-behavioral therapy, patient navigation, self-management support intervention, and information sharing with a primary physician.

Findings

As a result of the study, it was found that each additional session that RED-D patient participants engaged in was associated with a decrease in 30- and 90-day readmissions. Readmissions within 30 days dropped from 10 percent amongst those who received RED alone to 3 percent amongst the participants that received three or more sessions of RED-D. Readmissions within 90 days dropped from 21 percent amongst those who received RED alone to 11 percent amongst the participants that received six or more sessions of RED-D.

Pull Quote

This intervention could help overcome barriers to transitional health care services for marginalized and underserved populations such as those living in rural and underserved communities, or those with disabilities.