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In an RCT study, OPAC (outreach, problem solving, adherence, continuity) approach to aftercare after suicide attempts had an effect. The present study used the OPAC method in a clinical setting on Amager Copenhagen to patients after suicide attempt (Group 1) and patients with suicide ideation (Group 2) in a real-world data (RWD) study. To study whether the OPAC method could provide real world evidence (RWE) for results from the RCT study and long-time prospects. This RWD study included 506 patients and followed them for 5 years. Kaplan–Meyer showed 5 years results. Risk factors for 5 years were calculated. 206 males (mean age 37.9) and 300 females (mean age 35.2) participated. A decline in survival accelerated after 3 years. After a 2-year follow-up, Group 1 had an attempted suicide rate of 12,2% and Group 2 5,4%. After 5 years the numbers were 18% and 10%. There were 3 completed suicides. Risk factors were: earlier suicide attempts, one or both parents or they themselves were alcohol/drug abusers, and a poor social network. Group 1 showed the same result as the intervention group in our earlier RCT study. Group 2 did better. Both groups did better than the control group from our RCT study. The OPAC effect was translated into the daily clinic. Risk factors were previous suicide attempts, alcohol and drug abuse and poor social networks. More specific therapy is needed for some patients to prevent relapse. Focus on enhancing a sense of belongingness and/or treating substance abuse. [ABSTRACT FROM AUTHOR]

Background:The Amager Project was initiated as a quasi-experimental study in 2005, based on an active outreach suicide preventive intervention inspired by the Norwegian Baerum Model. A 1-year follow-up study was conducted as a randomized controlled trial showing that this kind of active outreach to suicide attempters had a significant preventive effect on the prevalence of suicide attempts and significantly reduced the number of patients repeating a suicide attempt. Aims:In this 5-year RCT follow-up the aim was to investigate the sustainability of the suicide preventive effect shown in a 1-year follow-up study. Method:One hundred and thirty-three suicide attempters were included at this 5-year follow-up RCT study at Copenhagen University Hospital, Amager, and randomized to a rapid outreach suicide preventive intervention (OPAC) or TAU. Results:Offering OPAC intervention to patients after a suicide attempt has a significant preventive effect on the total of suicide attempts and significantly reduces the number of patients repeating a suicide attempt. The suicide preventive effect lasts up to 265 weeks. After 3–4 years the effect on the number of patients repeating a suicide attempt is no longer sustainable, while the effect on the number of repetitive events remains significant. Conclusion:This study emphasizes the importance of a rapid and active outreach intervention and points out that the effect on the number of patients repeating a suicide attempt wears off and is no longer sustainable after 3–4 years, suggesting the need for a follow-up intervention. [ABSTRACT FROM PUBLISHER]