Hostname: page-component-586b7cd67f-2brh9 Total loading time: 0 Render date: 2024-11-26T18:09:52.177Z Has data issue: false hasContentIssue false
  • English
  • Français

The impact of routine outcome measurement on treatment processes in community mental health care: approach and methods of the MECCA study

Published online by Cambridge University Press:  11 October 2011

Stefan Priebe ,
Rosemarie McCabe ,
Jens Bullenkamp ,
Lars Hansson ,
Wulf Rössler ,
Francisco Torres-Gonzales  and
Durk Wiersma
Get access Rights & Permissions [Opens in a new window]

Summary

Three issues characterise the background to the MECCA study: A) Throughout Europe, most patients with severe forms of psychotic disorders are cared for in the community. The challenge now is to make processes in community mental health care more effective. B) There are widespread calls to implement regular outcome measurement in routine settings. This, however, is more likely to happen, if it provides a direct benefit to clinicians and patients. C) Whilst user involvement is relatively ?" easy to achieve on a political level, new mechanisms may have to be established to make the views of patients feed into individual treatment decisions. The MECCA study is a cluster randomised controlled trial following the same protocol in community mental health teams in six European countries. In the experimental group, patients' subjective quality of life, treatment satisfaction and wishes for different or additional help are assessed in key worker-patient meetings every two months and intended to inform the therapeutic dialogue and treatment decisions. The trial tests the hypothesis that the intervention – as compared to current best standard practice – will lead to a better outcome in terms of quality of life and other criteria in patients with psychotic disorders over a one year period. This more favourable outcome is assumed to be mediated through different treatment input based on more appropriate joint decisions or a more positive therapeutic relationship in line with a partnership model of care or both. Moreover, the study will hopefully reveal new insights into how therapeutic processes in community mental health care work and how they can be optimised.

Keywords

outcome managementcommunity mental healt careQOLRCTtherapeutic relationships
Type
Research Article
Information
Epidemiology and Psychiatric Sciences , Volume 11 , Issue 3 , September 2002 , pp. 198 - 205
Copyright
Copyright © Cambridge University Press 2002

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

REFERENCES

Angermeyer, M.C., Holzinger, A., Killian, R. & Matschinger, H. (2001). Quality of life – as defined by schizophrenic patients and psychiatrists. International Journal of Social Psychiatry 47, 34–42.CrossRefGoogle ScholarPubMed
Awad, A.G. & Voruganti, L.N.P. (2000). Intervention research in psychosis: issues related to the assessment of quality of life. Schizophrenia Bulletin 26, 557–564.CrossRefGoogle Scholar
Bertakis, D., Roter, D. & Putnam, S.M. (1991). The relationship of physician medical interview style to patient satisfaction. Journal of Family Practice 32, 175–181.Google ScholarPubMed
Brill, P.L., Lish, J.D. & Grissom, G.R. (1995). Timing is everything: pre-post versus concurrent measurement. Behavioral Healthcare Tomorrow 4, 76–77.Google ScholarPubMed
Britten, N., Stevenson, F.A., Barry, C.A., Barber, N. & Bradley, C.P. (2000). Misunderstandings in prescribing decisions in general practice: qualitative study. British Medical Journal 320, 184–188.CrossRefGoogle ScholarPubMed
Burgess, P. & Pirkis, J. (1999). The currency of case management: benefits and costs. Current Opinion in Psychiatry 12, 195–199.CrossRefGoogle Scholar
Department of Health (1997). The New NHS: Modern, Dependable. Department of Health: London.Google Scholar
Department of Health (1999). The National Service Framework for Mental Health. Department of Health: London..Google Scholar
Ellwood, P.M. (1998). Shattuck lecture – Outcomes management. A technology of patient experience. New England Journal of Medicine 318, 1549–1556.CrossRefGoogle Scholar
Fakhoury, W. & Priebe, S. (2002). The process of deinstitutionalization: an international overview. Current Opinion in Psychiatry 15, 187–192.CrossRefGoogle Scholar
Frank, A.F. & Gunderson, J.G. (1990). The role of the therapeutic alliance in the treatment of schizophrenia. Archives of General Psychiatry 47, 228–236.CrossRefGoogle ScholarPubMed
Gaston, L., Thompson, L., Gallagher, D., Cournoyer, L. & Gagnon, R. (1998). Alliance, technique, and their interactions in predicting outcome of behavioural, cognitive, and brief dynamic therapy. Psychotherapy Research 8, 190–209.CrossRefGoogle Scholar
Harrison, G. & Eaton, W.W. (1999). From research world to real world: routine outcome measures are the key. Current Opinion in Psychiatry 12, 187–189.CrossRefGoogle Scholar
Herrman, H. (2000). Assessing quality of life in people living with psychosis. Epidemiologia e Psichiatria Sociale 9, 1–6.CrossRefGoogle ScholarPubMed
Kaiser, W. & Priebe, S. (1999). The impact of the interviewer-interviewee relationship on subjective quality of life ratings in schizophrenia patients. International Journal of Social Psychiatry 45, 276–283.CrossRefGoogle ScholarPubMed
Killian, R. & Angermeyer, M.C. (1999). Quality of life in psychiatry as an ethical duty: from the clinical to the societal perspective. Psychopathology 32, 127–134.CrossRefGoogle Scholar
Krupnick, J.L., Sotsky, S.M., Simmens, S., Moyer, J., Elkin, I., Watkins, J. & Pilkonis, P.A. (1996). The role of the therapeutic alliance in psychotherapy and pharmacotherapy outcome: findings in the National programme. Journal of Consulting and Clinical Psychology 64,532–539.CrossRefGoogle Scholar
Lambert, E.W., Doucette, A. & Bickman, L. (2001). Measuring mental health outcomes with pre-post designs. Journal of Behavioural Health Services and Research 28, 273–286.CrossRefGoogle ScholarPubMed
Lauer, G. (1999). Concepts of quality of life in mental health care. In Quality of Life and Mental Health Care (ed. Priebe, S. et al. ). Wrightson Biomedical Publishing: Petersfield, UK.Google Scholar
Lehman, A. (1983). The well-being of chronic mental patients. Archives of General Psychiatry 40, 369–373.CrossRefGoogle ScholarPubMed
Lelliot, P., Beevor, A., Hogman, G., Hyslop, J., Lathlean, J. & Ward, M. (2001). Carers' and users' expectations of services – user version (CUES-U): a new instrument to measure the experience of users of mental health services. British Journal of Psychiatry 179, 67–72.CrossRefGoogle Scholar
Little, P., Everitt, H., Williamson, I., Warner, G., Moore, M., Gould, C., Ferrier, K. & Payne, S. (2001). Observational study of effect of patient centredness and positive approach on outcomes of general practice consultations. British Medical Journal 323, 908–911.CrossRefGoogle ScholarPubMed
Marks, I. (1998). Overcoming obstacles to routine outcome measurement: the nuts and bolts of implementing clinical audit. British Journal of Psychiatry 173, 281–286.CrossRefGoogle ScholarPubMed
McCabe, R. & Priebe, S. (2002). Focussing on quality of life in treatment. International Review of Psychiatry 14, 225–230.CrossRefGoogle Scholar
McCabe, R. & Priebe, S. (in press). The terapeutic relationship in the treatment of severe mental illness: a review of methods and findings. International Journal of Social Psychiatry.Google Scholar
McGuire, R., McCabe, R. & Priebe, S. (2001), Theoretical frameworks for understanding and investigating the therapeutic relationship in psychiatry. Social Psychiatry and Psychiatric Epidemiology 36, 557–564,CrossRefGoogle ScholarPubMed
Neale, M.S. & Rosenheck, R.A. (1995). Therapeutic alliance and outcome in a VA intensive case management programme. Psychiatric Services 46, 719–721.Google Scholar
Perkins, R. (2001). What constitutes success? The relative priority of service users' and clincians' views of mental health services. British Journal of Psychiatry 179, 9–10.CrossRefGoogle Scholar
Priebe, S. (1999). Research in quality of life in mental health care: aims and strategies. In Quality of Life and Mental Health Care (ed. Priebe, S. et al. ). Wrightson Biomedical Publishing: Petersfield, UK.Google Scholar
Priebe, S. (2000). Ensuring and improving quality in community mental health care. International Review of Psychiatry 12, 226–232.CrossRefGoogle Scholar
Priebe, S. & Broker, M. (1999). Prediction of hospitalizations by schizophrenia patients' assessment of treatment: an expanded study. Journal of Psychiatric Research 33, 113–119.CrossRefGoogle ScholarPubMed
Priebe, S. & Gruyters, T. (1995a). Patients' assessment of treatment predicting outcome. Schizophrenia Bulletin 21, 87–94CrossRefGoogle ScholarPubMed
Priebe, S. & Gruyters, T. (1995b). The importance of the first three days - Predictors of treatment outcome in depressed in-patients. British Journal of Clinical Psychology 34, 229–236.CrossRefGoogle ScholarPubMed
Priebe, S. & Gruyters, T. (1999). A pilot trial of treatment changes according to schizophrenic patients' wishes. Journal of Nervous and Mental Disease 187, 441–443CrossRefGoogle ScholarPubMed
Priebe, S., Kaiser, W., Huxley, P.J., Roder-Wanner, U. & Rudolf, H. (1998). Do different subjective evaluation criteria reflect distinct constructs? Journal of Nervous and Mental Disease 186, 385–392.CrossRefGoogle ScholarPubMed
Roter, D., Stewart, M., Putnam, S.M., Lipkin, M. Jr., Stiles, W. & Inui, T.S. (1997). Communication patterns of primary care physicians. Journal of the American Medical Association 277,350–356.CrossRefGoogle ScholarPubMed
Ryan, C.S., Sherman, P.S. & Judd, C.M. (1994). Accounting for case manager effects in the evaluation of mental health services. Journal of Consulting and Clinical Psychology 62, 965–974.CrossRefGoogle ScholarPubMed
Salvador-Carulla, L. (1999). Routine outcome assessment in mental health research. Current Opinion in Psychiatry 12, 207–210.CrossRefGoogle Scholar
Schmiedebach, H.-P., Bedddies, T., Schulz, J. & Priebe, S. (2000). Open care - Rodewisch Theses - psychiatry-enquete: Comparison of three reform approaches (in German). Psychiatrische Praxis 27, 138–143.Google Scholar
Shepherd, G., Murray, A. & Muijen, M. (1995). Perspectives on schizophrenia: the views of users, relatives and professionals. Journal of Mental Health 4, 403–422.CrossRefGoogle Scholar
Slade, M., Thornicroft, G. & Glover, G. (1999). The feasibility of routine outcome measures in mental health. Social Psychiatry and Psychiatric Epidemiology 34, 244–250.CrossRefGoogle ScholarPubMed
Slade, M. (in press). Routine outcome assessment in mental health services. Psychological Medicine.Google Scholar
Smith, G.R., Fischer, E.P., Nordquist, C.R., Mosley, C.L. & Ledbetter, N.S. (1997). Implementing outcomes management systems in mental health settings. Psychiatric Services 48, 364–368.Google ScholarPubMed
Solomon, P., Draine, J. & Delaney, M.A. (1995). The working alliance and consumer case management. Journal of Mental Health Administration 22, 126–134.CrossRefGoogle ScholarPubMed
Stewart, M. (1984). What is a successful doctor-patient interview? A study of interactions and outcomes. Social Science and Medicine 19, 167–175.CrossRefGoogle ScholarPubMed
Svensson, B. & Hansson, L. (1999). Therapeutic alliance in cognitive therapy for schizophrenic and other long-term mentally ill patients: development and relationship to outcome in an in-patient treatment programme. Ada Psychiatrica Scandinavica 99,281–287.CrossRefGoogle Scholar
Tattan, T. & Tarrier, N. (2000). The expressed emotion of case managers of the seriously mentally ill: the influence of expressed emotion on clinical outcomes. Psychological Medicine 30, 195–204.CrossRefGoogle ScholarPubMed
Van Nieuwenhuizen, C., Schene, A.H., Boevink, W.A. & Wolf, J.R.L.M. (1997). Measuring the quality of life of clients with severe mental illness: a review of instruments. Psychiatric Rehabilitation Journal 20, 33–41.Google Scholar
Voruganti, L.N.P., Heslegrave, R.J., Awad, A.G. & Seeman, M.V. (1998). Quality of life measurement in schizophrenia: reconciling the quest for subjectivity with the question of reliability. Psychological Medicine 28, 165–172.CrossRefGoogle ScholarPubMed
Warner, R. (1999). The emics and etics of quality of life assessment. Social Psychiatry and Psychiatric Epidemiology 34, 117–121.CrossRefGoogle ScholarPubMed