Study design of the Routine Outcome Monitoring for Geriatric Psychiatry & Science (ROM-GPS) project; a cohort study of older patients with affective disorders referred for specialised geriatric mental health care

Abstract BackGround Studies on feedback in youth mental health care are scarce and implementation of feedback into clinical practice is problematic. Objective To investigate potentially effective components of feedback from Routine Outcome Monitoring (ROM) in youth mental health care in the Netherlands through a three-arm, parallel-group, randomized controlled trial in which a literature-based, multi-faceted implementation strategy was used. Method Participants were randomly allocated to three conditions (basic feedback about symptoms and quality of life; basic feedback supplemented with clinical support tools; discussion of the feedback of the second condition with a colleague while following a standardized format for case consultation) using a block randomization procedure, stratified by location and participants’ age. The youth sample consisted of 225 participants (mean age = 15.08 years; 61.8% female) and the parent sample of 234 mothers and 54 fathers (mean age of children = 12.50 years; 47.2% female). Primary outcome was symptom severity. Secondary outcomes were quality of life and end-of-treatment variables. Additionally, we evaluated whether being Not On Track (NOT) moderated the association between condition and changes in symptom severity. Results No significant differences between conditions and no moderating effect of being NOT were found. This outcome can probably be attributed to limited power and implementation difficulties, such as infrequent ROM, unknown levels of viewing and sharing of feedback, and clinicians’ poor adherence to feedback conditions. Conclusions The study contributes to our limited knowledge about feedback from ROM and underscores the complexity of research on and implementation of ROM within youth mental health care. Trial registration Dutch Trial Register NTR4234 .

Download Full-text

Routine Outcome Monitoring in Mental Health Care and Particularly in Addiction Treatment: Evidence-Based Clinical and Research Recommendations

Journal of Addiction Research & Therapy ◽

10.4172/2155-6105.1000332 ◽

2017 ◽

Vol 08 (04) ◽

Cited By ~ 5

Author(s):

Ingrid VE Carlier ◽

Wessel A van Eeden

Keyword(s):

Mental Health ◽

Health Care ◽

Mental Health Care ◽

Addiction Treatment ◽

Routine Outcome Monitoring ◽

Evidence Based ◽

Outcome Monitoring ◽

Research Recommendations

Download Full-text

Exploring the use of Routine Outcome Monitoring in the treatment of patients with a psychotic disorder

European Psychiatry ◽

10.1016/j.eurpsy.2016.12.008 ◽

2017 ◽

Vol 42 ◽

pp. 89-94 ◽

Cited By ~ 6

Author(s):

M. Tasma ◽

E.J. Liemburg ◽

H. Knegtering ◽

P.A.E.G. Delespaul ◽

A. Boonstra ◽

...

Keyword(s):

Mental Health ◽

Health Care ◽

Clinical Practice ◽

Mental Health Care ◽

Psychotic Disorder ◽

Treatment Process ◽

Treatment Plan ◽

Ease Of Use ◽

Routine Outcome Monitoring ◽

Outcome Monitoring

AbstractBackgroundRoutine Outcome Monitoring (ROM) has become part of the treatment process in mental health care. However, studies have indicated that few clinicians in psychiatry use the outcome of ROM in their daily work. The aim of this study was to explore the degree of ROM use in clinical practice as well as the explanatory factors of this use.MethodsIn the Northern Netherlands, a ROM-protocol (ROM-Phamous) for patients with a psychotic disorder has been implemented. To establish the degree of ROM-Phamous use in clinical practice, the ROM results of patients (n = 204) were compared to the treatment goals formulated in their treatment plans. To investigate factors that might influence ROM use, clinicians (n = 32) were asked to fill out a questionnaire about ROM-Phamous.ResultsCare domains that were problematic according to the ROM-Phamous results were mentioned in the treatment plan in 28% of cases on average (range 5–45%). The use of ROM-Phamous in the treatment process varies considerably among clinicians. Most of the clinicians find ROM-Phamous both useful and important for good clinical practice. In contrast, the perceived ease-of-use is low and most clinicians report insufficient time to use ROM-Phamous.ConclusionsMore frequent ROM use should be facilitated in clinicians. This could be achieved by improving the fit with clinical routines and the ease-of-use of ROM systems. It is important for all stakeholders to invest in integrating ROM in clinical practice. Eventually, this might improve the diagnostics and treatment of patients in mental health care.

Download Full-text

The Assessment and Impact of Careless Responding in Routine Outcome Monitoring within Mental Health Care

Multivariate Behavioral Research ◽

10.1080/00273171.2018.1563520 ◽

2019 ◽

Vol 54 (4) ◽

pp. 593-611 ◽

Cited By ~ 3

Author(s):

Judith M. Conijn ◽

Gunhild Franz ◽

Wilco H. M. Emons ◽

Edwin de Beurs ◽

Ingrid V. E. Carlier

Keyword(s):

Mental Health ◽

Health Care ◽

Mental Health Care ◽

Routine Outcome Monitoring ◽

Outcome Monitoring ◽

Careless Responding

Download Full-text

Routine outcome monitoring and process quality in mental health care: a descriptive study in daily practice

Journal of Evaluation in Clinical Practice ◽

10.1111/jep.12352 ◽

2015 ◽

Vol 21 (4) ◽

pp. 620-625 ◽

Cited By ~ 5

Author(s):

Wim Siebum ◽

Ysbrand J. Pijl ◽

G. Sander de Wolf

Keyword(s):

Mental Health ◽

Health Care ◽

Mental Health Care ◽

Daily Practice ◽

Descriptive Study ◽

Process Quality ◽

Routine Outcome Monitoring ◽

Outcome Monitoring

Download Full-text

Trends in treatment for patients with depression in general practice in Norway, 2009–2015: nationwide registry-based cohort study (The Norwegian GP-DEP Study)

BMC Health Services Research ◽

10.1186/s12913-021-06712-w ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Sabine Ruths ◽

Inger Haukenes ◽

Øystein Hetlevik ◽

Tone Smith-Sivertsen ◽

Stefan Hjørleifsson ◽

...

Keyword(s):

Mental Health ◽

Health Care ◽

General Practice ◽

Cohort Study ◽

Drug Treatment ◽

Time Trends ◽

Older Patients ◽

Antidepressant Drug ◽

Depression Care ◽

Patient Gender

Abstract Background Depression is highly prevalent, but knowledge is scarce as to whether increased public awareness and strengthened government focus on mental health have changed how general practitioners (GPs) help their depressed patients. This study aimed to examine national time trends in GP depression care and whether trends varied regarding patient gender, age, and comorbidity. Methods Nationwide registry-based cohort study, Norway. The study population comprised all residents aged 20 years or older with new depression diagnoses recorded in general practice, 2009–2015. We linked reimbursement claims data from all consultations in general practice for depression with information on demographics and antidepressant medication. The outcome was type(s) of GP depression care during 12 months from the date of diagnosis: (long) consultation, talking therapy, antidepressant drug treatment, sickness absence certification, and referral to secondary mental health care. Covariates were patient gender, age, and comorbidity. The data are presented as frequencies and tested with generalized linear models. Results We included 365,947 new depression diagnoses. Mean patient age was 44 years (SD = 16), 61.9 % were women, 41.2 % had comorbidity. From 2009 to 2015, proportions of patients receiving talking therapy (42.3–63.4 %), long consultations (56.4–71.8 %), and referral to secondary care (16.6–21.6 %) increased, while those receiving drug treatment (31.3–25.9 %) and sick-listing (58.1–50 %) decreased. The trends were different for gender (women had a greater increase in talking therapy and a smaller decrease in sick-listing, compared to men), age (working-aged patients had a smaller increase in talking therapy, a greater increase in long consultations, and a smaller decrease in antidepressant drug use, compared to older patients) and comorbidity (patients with mental comorbidity had a smaller increase in talking therapy and a greater increase in long consultations, compared to those with no comorbidity and somatic comorbidity). Conclusions The observed time trends in GP depression care towards increased provision of psychological treatment and less drug treatment and sick-listing were in the desired direction according to Norwegian health care policy. However, the large and persistent differences in treatment rates between working-aged and older patients needs further investigation.

Download Full-text

Perceived need for mental health care: influences of diagnosis, demography and disability

Psychological Medicine ◽

10.1017/s0033291701004913 ◽

2002 ◽

Vol 32 (2) ◽

pp. 299-309 ◽

Cited By ~ 53

Author(s):

G. MEADOWS ◽

P. BURGESS ◽

I. BOBEVSKI ◽

E. FOSSEY ◽

C. HARVEY ◽

...

Keyword(s):

Mental Health ◽

Health Care ◽

Mental Health Care ◽

Affective Disorders ◽

Mental Health Problems ◽

Reliability And Validity ◽

Composite International Diagnostic Interview ◽

Detailed Examination ◽

Perceived Need ◽

Co Morbidity

Background. Recent major epidemiological studies have adopted increasingly multidimensional approaches to assessment. Several of these have included some assessment of perceived need for mental health care. The Australian National Survey of Mental Health and Wellbeing, conducted in 1997, included a particularly detailed examination of this construct, with an instrument with demonstrated reliability and validity.Methods. A clustered probability sample of 10641 Australians responded to the field questionnaire for this survey, including questions on perceived need either where there had been service utilization, or where a disorder was detected by administration of sections of the Composite International Diagnostic Interview. The confidentialized unit record file generated from the survey was analysed for determinants of perceived need.Results. Perceived need is increased in females, in people in the middle years of adulthood, and in those who have affective disorders or co-morbidity. Effects of diagnosis and disability can account for most of the differences in gender specific rates. With correction for these effects through regression, there is less perceived need for social interventions and possibly more for counselling in females; disability is confirmed as strongly positively associated with perceived need, as are the presence of affective disorders or co-morbidity.Conclusions. The findings of this study underscore the imperative for mental health services to be attentive and responsive to consumer perceived need. The substantial majority of people who are significantly disabled by mental health problems are among those who see themselves as having such needs.

Download Full-text

Approaches to assessing the impact of robotics in geriatric mental health care: a scoping review

International Review of Psychiatry ◽

10.1080/09540261.2020.1839391 ◽

2021 ◽

pp. 1-11

Author(s):

Emily Kulpa ◽

Aniqa T. Rahman ◽

Ipsit V. Vahia

Keyword(s):

Mental Health ◽

Health Care ◽

Mental Health Care ◽

Scoping Review ◽

Geriatric Mental Health ◽

The Impact

Download Full-text

The Use of Antidepressants, Anxiolytics, Sedatives and Hypnotics in Europe: Focusing on Mental Health Care in Portugal and Prescribing in Older Patients

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph17228612 ◽

2020 ◽

Vol 17 (22) ◽

pp. 8612

Author(s):

Marta Estrela ◽

Maria Teresa Herdeiro ◽

Pedro Lopes Ferreira ◽

Fátima Roque

Keyword(s):

Mental Health ◽

Health Care ◽

Mental Disorders ◽

Mental Health Care ◽

Older Patients ◽

Common Mental Disorders ◽

Health Policies ◽

Depression And Anxiety ◽

Treatment Gap ◽

Mental Health Policies

(1) Background: Mental disorders are a growing concern in the 21st century. The most prevalent common mental disorders include depression and anxiety. It is predicted that half of the population will at some point in their lives experience one or more mental disorders. Although common mental disorders are highly prevalent, some of the most significant related problems are the wide treatment gap and the excessive use of antidepressants, anxiolytics and sedatives/hypnotics, especially among older patients. (2) Methods: This study aimed to analyze mental health care in Portugal, with a focus on the consumption of antidepressants, anxiolytics, sedatives and hypnotics among older patients. (3) Results: The use of antidepressants, anxiolytics, sedatives and hypnotics has increased overall across Europe. In Portugal, a downward trend of sedatives and hypnotics consumption can be observed. Anxiolytics and antidepressants, on the other hand, have been increasing. Patients aged ≥60 years old consume more than half of the aforementioned drugs. (4) Conclusions: Mental health policies should be designed to improve the conscientious use of antidepressants, anxiolytics, sedatives and hypnotics, particularly among older adults.

Download Full-text