scholarly journals On poverty, politics and psychology: the socioeconomic gradient of mental healthcare utilisation and outcomes

2016 ◽  
Vol 209 (5) ◽  
pp. 429-430 ◽  
Author(s):  
Jaime Delgadillo ◽  
Miqdad Asaria ◽  
Shehzad Ali ◽  
Simon Gilbody
Keyword(s):  
Mental Health Problems ◽  
Mental Healthcare ◽  
Healthcare Utilisation ◽  
Patient Reported Outcome Measures ◽  
Patient Reported Outcome ◽  
Depression And Anxiety ◽  
Local Index ◽  
Psychological Therapies ◽  
Socioeconomic Gradient ◽  
Patient Reported

SummarySince 2008, the Improving Access to Psychological Therapies (IAPT) programme has disseminated evidence-based interventions for depression and anxiety problems. In order to maintain quality standards, government policy in England sets the expectation that 50% of treated patients should meet recovery criteria according to validated patient-reported outcome measures. Using national IAPT data, we found evidence suggesting that the prevalence of mental health problems is greater in poorer areas and that these areas had lower average recovery rates. After adjusting benchmarks for local index of multiple deprivation, we found significant differences between unadjusted (72.5%) and adjusted (43.1%) proportions of underperforming clinical commissioning group areas.

A tale of 2,000 charts: Measuring provider response to patient-reported outcome measures.

2018 ◽  
Vol 36 (30_suppl) ◽  
pp. 157-157
Author(s):  
Gillian Hurwitz ◽  
Zahra Ismail ◽  
Lesley Moody ◽  
Lisa Catherine Barbera
Keyword(s):  
Outcome Measures ◽  
Patient Reported Outcome Measures ◽  
Physical Symptoms ◽  
Patient Reported Outcome ◽  
Assessment System ◽  
Screening Methods ◽  
Depression And Anxiety ◽  
Chart Audit ◽  
Symptom Screening ◽  
Patient Reported

157 Background: Patients undergoing cancer treatment often experience physical and psychosocial symptoms that go undetected by clinicians, which highlights the need to incorporate patient-reported outcome measures (PROMs) in routine care. Systematic symptom screening for cancer patients using the Edmonton Symptom Assessment System (ESAS) is standard practice in Ontario. However, provider response to PROMs is essential to addressing symptom burden. To measure provider response, Regional Cancer Centre (RCC) Leads and Cancer Care Ontario developed a chart audit process. The objective was to determine whether the clinical team acknowledged, assessed and/or addressed symptoms identified by ESAS screening. Methods: RCCs received a chart audit tool with preset options and a data dictionary. Sites audited at least 140 charts for seven of the ESAS symptoms. Sites used a business intelligence tool to access patient charts based on sampling parameters. RCCs were required to audit charts of patients whose ESAS symptom scores were moderate to severe (4-10), with at least five charts in the moderate range (4-6). Results: 2,380 charts from 13 RCCs were audited based on ESAS scores from September to December 2016. Symptoms were most often acknowledged when the intensity was severe (69.9%), regardless of symptom type. Acknowledgement (71.5%), assessment (67.7%) and intervention (55.8%) were most often offered to patients reporting pain. Patients reporting depression and anxiety were the least likely to have the symptom acknowledged (44.5%, 45.0%, respectively) and be offered assessments (45.8%, 50.1%, respectively) and interventions (35.7%, 36.6%, respectively). Patients reporting moderate to severe depression and anxiety most commonly declined interventions (7.8%, 7.7%, respectively). Conclusions: These data show that providers disproportionately respond to physical symptoms, which may be easiest to treat due to clear management plans and referral pathways. To truly offer person-centred care, the emotional burden related to cancer must also be addressed, and providers must be trained to properly respond to psychosocial symptoms. Chart audits identify gaps in symptom management and areas for quality improvement.

Identifying barriers to the implementation of patient-reported outcome measures using a theory-based approach

2017 ◽  
Vol 5 (1) ◽  
pp. 35 ◽  
Author(s):  
Andria Hanbury
Keyword(s):  
Data Collection ◽  
Outcome Measures ◽  
Mental Healthcare ◽  
Patient Reported Outcome Measures ◽  
Patient Reported Outcome ◽  
Ease Of Use ◽  
Mental Wellbeing ◽  
Relative Advantage ◽  
Routine Practice ◽  
Patient Reported

Rationale, aims and objectives: Patient-reported outcome measures (PROMs) are gaining increasing attention within mental healthcare, yet can be difficult to implement into routine practice. To increase uptake, it is recommended to explore the barriers to uptake guided by a theory base, with this information then used to design a tailored improvement strategy. The aim of this study was to explore the barriers to collecting and using a specific PROM within a single setting to inform the design of PROMs promotion strategies.Methods: Staff perceptions of relative advantage and the compatibility with norms and complexity of using the Short Warwick Edinburgh Mental Wellbeing Scale (SWEMWBS) in routine practice were explored through structured group discussions with mental healthcare teams within one Foundation Trust guided by diffusion of innovation theory. Results: Respondents perceived some advantages to using SWEMWBS, notably patient involvement, but also highlighted the burden of paper-based data collection and the poor quality of feedback reports. There was also scepticism regarding the suitability of the tool, particularly for certain groups of patients and concerns regarding use of PROMs for performance management. Views were mixed regarding compatibility with existing norms. Conclusions: To increase uptake, it is recommended that the positive perceptions of relative advantage, compatibility and ease of use identified in this study should be promoted, including through messages delivered by senior staff and tailored educational strategies. Negative (mis)perceptions should be similarly challenged and barriers around paper-based data collection and feedback reports systematically targeted.

Optimizing electronic capture of patient-reported outcome measures in oncology clinical trials: lessons learned from a qualitative study

2020 ◽  
Vol 9 (17) ◽  
pp. 1195-1204
Author(s):  
Florence D Mowlem ◽  
Brad Sanderson ◽  
Jill V Platko ◽  
Bill Byrom
Keyword(s):  
Patient Reported Outcome Measures ◽  
Patient Reported Outcome ◽  
Lessons Learned ◽  
Structured Interviews ◽  
Patient Reported ◽  
Oncology Clinical Trials ◽  
Anticancer Treatment ◽  
Fit For Purpose ◽  
The Impact ◽  
Electronic Implementation

Aim: To understand the impact of anticancer treatment on oncology patients’ ability to use electronic solutions for completing patient-reported outcomes (ePRO). Materials & methods: Semi-structured interviews were conducted with seven individuals who had experienced a cancer diagnosis and treatment. Results: Participants reported that the following would impact the ability to interact with an ePRO solution: peripheral neuropathy of the hands (4/7), fatigue and/or concentration and memory issues (6/7), where they are in a treatment cycle (5/7). Approaches to improve usability included: larger, well-spaced buttons to deal with finger numbness, the ability to pause a survey and complete at a later point and presenting the recall period with every question to reduce reliance on memory. Conclusion: Symptoms associated with cancers and anticancer treatments can impact the use of technologies. The recommendations for optimizing the electronic implementation of patient-reported outcome instruments in this population provides the potential to improve data quality in oncology trials and places patient needs at the forefront to ensure ‘fit-for-purpose’ solutions.

Impact of Depression on Patient-Reported Outcome Measures After Lumbar Spine Decompression

Spine ◽  
2018 ◽  
Vol 43 (6) ◽  
pp. 434-439 ◽  
Author(s):  
Robert K. Merrill ◽  
Lukas P. Zebala ◽  
Colleen Peters ◽  
Sheeraz A. Qureshi ◽  
Steven J. McAnany
Keyword(s):  
Lumbar Spine ◽  
Outcome Measures ◽  
Patient Reported Outcome Measures ◽  
Patient Reported Outcome ◽  
Patient Reported

scholarly journals The effects of competition and bundled payment on patient reported outcome measures after hip replacement surgery

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Fanny Goude ◽  
Sverre A. C. Kittelsen ◽  
Henrik Malchau ◽  
Maziar Mohaddes ◽  
Clas Rehnberg
Keyword(s):  
Hip Replacement ◽  
Health Gain ◽  
Patient Reported Outcome Measures ◽  
Patient Reported Outcome ◽  
Economic Incentives ◽  
Bundled Payment ◽  
Treatment Groups ◽  
Replacement Surgery ◽  
Hip Replacement Surgery ◽  
Patient Reported

Abstract Background Competition-promoting reforms and economic incentives are increasingly being introduced worldwide to improve the performance of healthcare delivery. This study considers such a reform which was initiated in 2009 for elective hip replacement surgery in Stockholm, Sweden. The reform involved patient choice of provider, free establishment of new providers and a bundled payment model. The study aimed to examine its effects on hip replacement surgery quality as captured by patient reported outcome measures (PROMs) of health gain (as indicated by the EQ-5D index and a visual analogue scale (VAS)), pain reduction (VAS) and patient satisfaction (VAS) one and six years after the surgery. Methods Using patient-level data collected from multiple national registers, we applied a quasi-experimental research design. Data were collected for elective primary total hip replacements that were carried out between 2008 and 2012, and contain information on patient demography, the surgery and PROMs at baseline and at one- and six-years follow-up. In total, 36,627 observations were included in the analysis. First, entropy balancing was applied in order to reduce differences in observable characteristics between treatment groups. Second, difference-in-difference analyses were conducted to eliminate unobserved time-invariant differences between treatment groups and to estimate the causal treatment effects. Results The entropy balancing was successful in creating balance in all covariates between treatment groups. No significant effects of the reform were found on any of the included PROMs at one- and six-years follow-up. The sensitivity analyses showed that the results were robust. Conclusions Competition and bundled payment had no effects on the quality of hip replacement surgery as captured by post-surgery PROMs of health gain, pain reduction and patient satisfaction. The study provides important insights to the limited knowledge on the effects of competition and economic incentives on PROMs.

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