Capturing and missing the patient's story through outcome measures: A thematic comparison of patient‐generated items in PSYCHLOPS with CORE‐OM and PHQ‐9

Abstract

BackgroundThere is increasing interest in individualized patient‐reported outcome measures (I‐PROMS), where patients themselves indicate the specific problems they want to address in therapy and these problems are used as items within the outcome measurement tool.ObjectiveThis paper examined the extent to which 279 items reported in an I‐PROM (PSYCHLOPS) added qualitative information which was not captured by two well‐established outcome measures (CORE‐OM and PHQ‐9).DesignComparison of items was only conducted for patients scoring above the “caseness” threshold on the standardized measures.Setting and patients107 patients were participating in therapy within addiction and general psychiatric clinical settings.Main resultsAlmost every patient (95%) reported at least one item whose content was not covered by PHQ‐9, and 71% reported at least one item not covered by CORE‐OM.DiscussionResults demonstrate the relevance of individualized outcome assessment for capturing data describing the issues of greatest concern to patients, as nomothetic measures do not always seem to capture the whole story.

“There Are Things I Want to Say But You Do Not Ask”: a Comparison Between Standardised and Individualised Evaluations in Substance Use Treatment

“…Responses were categorised according to their content, or subtheme, based on a previously validated thematic classification system. This classification system comprised of 65 mutually exclusive sub-themes of problems and was created to analyse PSYCHLOPS items (Robinson et al 2006;Sales et al 2018). We used this classification system to allow for our findings to be compared with previous studies and to increase the robustness of our categorisation procedure.…”

How Routine Patient‐Centered Monitoring Relates to Therapeutic Gains in Family Therapy: A Single‐Case Study

“…Have to look individually" (Norman et al, 2014, p. 586). By including items indicated by patients themselves, PQ and other outcome PGM allow monitoring progress on case-specific issues that are not captured by their nomothetic counterparts they introduce novelty (Ashworth et al, 2007;Sales, Neves, Alves, & Ashworth, 2017) that is valued and used by therapists (Antunes et al, 2018;Barkham, 2016), while also perceived by patients as useful for promoting self-reflection (Alves, Sales, & Ashworth, 2016;Guerra, Sales, & Pereira, 2018). Besides IPPS, which uses PQ, the MFT-PRN (Johnson et al, 2017) also offers this possibility, by including in the intake questionnaire the top three presenting problems indicated by each family member, which are scored for intensity on a weekly basis.…”

Individualised or Standardised Outcome Measures: A Co-habitation?

“…Several recent studies have reported on distress captured by idiographic instruments but 'missed' by commonly used nomothetic instruments. In one study within an addiction and general psychiatric setting, over two-thirds of themes identified on the idiographic instrument PSYCHLOPS ('Psychological Outcome Profiles') did not feature in nomothetic comparators (Sales et al 2017). The authors concluded that conventional measures might both capture and miss the patient story (ibid).…”