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The effects of a computerized clinical decision aid on clinical decision-making and guideline implementation in psychosis care

Published online by Cambridge University Press:  01 September 2022

S. Castelein ,
L.O. Roebroek ,
A. Boonstra ,
W. Veling ,
F. Jörg ,
B. Sportel ,
J. Bruins  and
P.A.E.G. Delespaul
S. Castelein*
Affiliation:
Lentis Psychiatric Institute, Lentis Research, Groningen, Netherlands University of Groningen, Clinical Psychology, Groningen, Netherlands
L.O. Roebroek
Affiliation:
Lentis Psychiatric Institute, Lentis Research, Groningen, Netherlands University of Groningen, Clinical Psychology, Groningen, Netherlands
A. Boonstra
Affiliation:
University of Groningen, Faculty Of Economics And Business, Groningen, Netherlands
W. Veling
Affiliation:
University Medical Center Groningen, University Center For Psychiatry, Groningen, Netherlands
F. Jörg
Affiliation:
University Medical Center Groningen, University Center For Psychiatry, Groningen, Netherlands
B. Sportel
Affiliation:
GGz Drenthe, Psychosis Department, Assen, Netherlands
J. Bruins
Affiliation:
Lentis Psychiatric Institute, Lentis Research, Groningen, Netherlands
P.A.E.G. Delespaul
Affiliation:
Maastricht University, School For Mental Health And Neurosciences, Maastricht, Netherlands Mondriaan, Research, Heerlen, Netherlands
*
*Corresponding author.

Abstract

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Introduction

Clinicians in mental healthcare have few objective tools to identify and analyse their patient’s care needs. Clinical decision aids are tools that can support this process.

Objectives

This study examines whether 1) clinicians working with a clinical decision aid (TREAT) discuss more of their patient’s care needs compared to usual treatment, and 2) agree on more evidence-based treatment decisions.

Methods

Clinicians participated in consultations (n=166) with patients diagnosed with psychotic disorders from four Dutch mental healthcare institutions. Primary outcomes were measured with the modified Clinical Decision-making in Routine Care questionnaire and combined with psychiatric, physical and social wellbeing related care needs. A multilevel analysis compared discussed care needs and evidence-based treatment decisions between treatment as usual (TAU) before, TAU after and the TREAT-condition.

Results

First, a significant increase in discussed care needs for TREAT compared to both TAU conditions (b = 20.2, SE = 5.2, p = 0.00 and b = 15.8, SE = 5.4, p = 0.01) was found. Next, a significant increase in evidence-based treatments decisions for care needs was observed for TREAT compared to both TAU conditions (b = 16.7, SE = 4.8, p = 0.00 and b = 16.0, SE = 5.1, p = 0.01).

Conclusions

TREAT improved the discussion about physical health issues and social wellbeing related topics. It also increased evidence-based treatment decisions for care needs which are sometimes overlooked and difficult to treat. Our findings suggest that TREAT makes sense of ROM data and improves guideline-informed care.

Disclosure

No significant relationships.

Type
Abstract
Information
European Psychiatry , Volume 65 , Special Issue S1: Abstracts of the 30th European Congress of Psychiatry , June 2022 , pp. S181
Creative Commons
Creative Common License - CCCreative Common License - BY
This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
Copyright
© The Author(s), 2022. Published by Cambridge University Press on behalf of the European Psychiatric Association
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