Directions for Future Patient-Centered and Comparative Effectiveness Research for People With Serious Mental Illness

Green, Carla A.; Estroff, Sue E.; Yarborough, Bobbi Jo H.; Spofford, Mark; Solloway, Michele; Kitson, Rachel; Perrin, Nancy

doi:10.1093/schbul/sbt170

Cited by 21 publications

(20 citation statements)

References 595 publications

(715 reference statements)

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“…Client-driven advocacy movements and national policy recommendations have inspired mental health care service systems to move toward a patient-centered care approach, which promotes individual agency and choice while emphasizing self-empowerment, self-direction, and mutual respect (Klingaman et al, 2015; Green et al, 2014; Stanghellini et al, 2013; Noiseux & Ricard, 2008; Bellack, 2006). However, the ways in which participants’ experiences and perspectives impact outcomes are still not well-understood.…”

Section: Introductionmentioning

confidence: 99%

Association of participant preferences on work and school participation after a first episode of psychosis

Waal

Dixon

Humensky

2017

Early Intervention Psych

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Section: Introductionmentioning

confidence: 99%

Association of participant preferences on work and school participation after a first episode of psychosis

Waal

Dixon

Humensky

2017

Early Intervention Psych

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“…Alongside specific interventions directly targeting PTSD in FEP, there is a widely identified need for a broad, service-wide understanding of, and intervention for, trauma-exposed mental health consumers that goes beyond the treatment of PTSD [17,18,19,20]. One name coined for this is “trauma-informed care”, a care model that is gaining traction across the world [18,19].…”

Section: Introductionmentioning

confidence: 99%

“…One name coined for this is “trauma-informed care”, a care model that is gaining traction across the world [18,19]. A major barrier to the implementation of trauma-informed care is a lack of evidence to support the model [20], which may stem from a lack of clear operationalisation [17]. There is a need in psychosis treatment services for both trauma-specific and trauma-informed approaches [21].…”

Section: Introductionmentioning

confidence: 99%

“…It is generally conceptualised as a collaborative endeavour between therapist and patient [23,24], and often forms the basis for the development of an individualised treatment plan [26]. There is high utility in using CF in both a trauma-informed and a trauma-specific intervention in FEP, as both models stress the importance of an understanding of the role of the trauma and peri-traumatic effects on presenting symptoms [12,17]. …”

Section: Introductionmentioning

confidence: 99%

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Case Formulation in Young People with Post-Traumatic Stress Disorder and First-Episode Psychosis

Halpin

Kugathasan

Hulbert

et al. 2016

JCM

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Background: Evidence based treatment interventions for young people with first-episode psychosis (FEP) and trauma histories is lacking. Although case formulation (CF) has been widely regarded in cognitive behavioural therapy manuals as beneficial, there is limited empirical research examining how clients and therapists experience the process. Aim: This study aimed to explore young people’s reactions to CF in treatment for PTSD (post-traumatic stress disorder) and FEP. Method: Semi-structured interviews were conducted with three participants (aged 19–20) with FEP and PTSD and their therapists, after they had completed a trauma-focused treatment program with a CF component. Transcripts were analysed using an interpretative phenomenological approach and themes were derived. Results: Two themes related to participants’ experiences were identified from the analysis: (1) Developing Insight; (2) A challenging experience; and two themes from the therapists: (1) Doing the case formulation; (2) Value of case formulation. Participants and therapists reported benefits in making connections between current symptoms and past trauma. Participants viewed the process as challenging. Conclusion: Results suggest a potential discrepancy between the experience of the case formulation process for clients and therapists.

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“… 19–21 Systematic reviews of studies applying the techniques to elicit patient preferences for outcomes of psychotropic drugs are lacking. The current void of knowledge on the outcomes patients value the most and least, and what those outcomes should be, 22 strikes the foundation of patient-centred care and suggests missed opportunities for more patient-centred decisions.…”

Section: Introductionmentioning

confidence: 99%

What matters to patients? A systematic review of preferences for medication-associated outcomes in mental disorders

et al. 2015

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ObjectiveTo investigate patients’ preferences for outcomes associated with psychoactive medications.Setting/designSystematic review of stated preference studies. No settings restrictions were applied.Participants/eligibility criteriaWe included studies containing quantitative data regarding the relative value adults with mental disorders place on treatment outcomes. Studies with high risk of bias were excluded.Primary and secondary outcome measuresWe restricted the scope of our review to preferences for outcomes, including the consequences from, attributes of, and health states associated with particular medications or medication classes, and process outcomes.ResultsAfter reviewing 11 215 citations, 16 studies were included in the systematic review. These studies reported the stated preferences from patients with schizophrenia (n=9), depression (n=4), bipolar disorder (n=2) and attention deficit hyperactive disorder (n=1). The median sample size was 81. Side effects and symptom outcomes outnumbered functioning and process outcomes. Severe disease and hospitalisation were reported to be least desirable. Patients with schizophrenia tended to value disease states as higher and side effects as lower, compared to other stakeholder groups. In depression, the ability to cope with activities was found to be more important than a depressed mood, per se. Patient preferences could not consistently be predicted from demographic or disease variables. Only a limited number of potentially important outcomes had been investigated. Benefits to patients were not part of the purpose in 9 of the 16 studies, and in 10 studies patients were not involved when the outcomes to present were selected.ConclusionsInsufficient evidence exists on the relative value patients with mental disorders place on medication-associated outcomes. To increase patient-centredness in decisions involving psychoactive drugs, further research—with outcomes elicited from patients, and for a larger number of conditions—should be undertaken.Trial registration numberPROSPERO CRD42013005685.

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Directions for Future Patient-Centered and Comparative Effectiveness Research for People With Serious Mental Illness

Cited by 21 publications

References 595 publications

Association of participant preferences on work and school participation after a first episode of psychosis

Association of participant preferences on work and school participation after a first episode of psychosis

Case Formulation in Young People with Post-Traumatic Stress Disorder and First-Episode Psychosis

What matters to patients? A systematic review of preferences for medication-associated outcomes in mental disorders

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