Measurement-Based Care Versus Standard Care for Major Depression: A Randomized Controlled Trial With Blind Raters

Guo, Tong; Xiang, Yu‐Tao; Xiao, Le; Hu, Changqing; Chiu, Helen F. K.; Ungvári, Gábor S.; Correll, Christoph U.; Lai, Kun; Feng, Lei; Geng, Ying; Feng, Yuan; Wang, Gang

doi:10.1176/appi.ajp.2015.14050652

Cited by 238 publications

(216 citation statements)

References 32 publications

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“…Yet it is increasingly recognized that PROMS should also be discussed with patients in routine medical encounters. 42,64,73 Such use has been theorized to (a) increase patients' motivation to complete PROMs 60 ; (b) improve management and monitoring of patients' problems 25,[74][75][76] ; (c) improve doctor-patient communication 25,77 ; and (d) improve SDM and informed patient decisions .. 39,40,42,74 PROMs are typically made available in the medical encounter through electronic health records and dashboards, 78,79 displaying individual, N = 1, PROMs scores of patients over time. There is not much experience yet on the merits of using PROMs in medical encounters, but the mere collection of PROMs is known to increase awareness of patients' concerns 80,81 and to enhance patient-provider communication.…”

Section: Use Of Proms In Medical Encounters With Patientsmentioning

confidence: 99%

The use of PROMs and shared decision‐making in medical encounters with patients: An opportunity to deliver value‐based health care to patients

Damman

Jani

Jong

et al. 2019

Evaluation Clinical Practice

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Background The recent emphasis on value‐based health care (VBHC) is thought to provide new opportunities for shared decision‐making (SDM) in the Netherlands, especially when using patient‐reported outcome measures (PROMs) in routine medical encounters. It is still largely unclear about how PROMs could be linked to SDM and what we expect from clinicians in this respect. Aim To describe approaches and lessons learned in the fields of SDM and VBHC implementation that converge in using PROMs in medical encounters. Approach Based on input from three Dutch forerunner case examples and available evidence about SDM and VBHC, we describe barriers and facilitators regarding the use of PROMs and SDM in the medical encounter. Barriers and facilitators were structured according to a conversational model that included monitoring and managing, team talk, option talk, choice talk, and decision talk. Key lessons learned and recommendations were synthesized. Results The use of individual, N = 1 PROMs scores in the medical encounter has been largely achieved in the forerunner projects. Conversation on monitoring and managing is relatively well implemented, and option talk to some extent, unlike team talk, and decision talk. Aggregated PROMs information describing outcomes of treatment options seemed to be scarcely used. Experienced barriers largely corresponded to what is known from the literature, eg, perceived lack of time and lack of tools summarizing the options. Some concerns were identified about increasing health care consumption as a result of using PROMs and SDM in the medical encounter. Conclusion Successful implementation of SDM within VBHC initiatives may not be self‐evident, even though individual, N = 1 PROMs scores are being used in the medical encounter. Education and staff resources on meso and macro levels may facilitate the more time‐consuming SDM aspects. It seems fruitful to especially target team talk and choice talk in redesigning clinical pathways.

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Section: Use Of Proms In Medical Encounters With Patientsmentioning

confidence: 99%

The use of PROMs and shared decision‐making in medical encounters with patients: An opportunity to deliver value‐based health care to patients

Damman

Jani

Jong

et al. 2019

Evaluation Clinical Practice

View full text Add to dashboard Cite

show abstract

“…For example, the nine-item Patient Health Questionnaire (PHQ-9) is a patient-reported symptom measure and is used as a screening and symptom measure of depressive symptoms (15). Using the PHQ-9 and similar instruments permits measurement-based care, which improves the quality of care and improves patient outcomes in comparison with usual care (16). However, screening for and measuring symptoms of bipolar disorder are more difficult than doing so for major depression because no instrument exists that works as both a screening and symptom measurement tool.…”

Section: Diagnosis In Primary Carementioning

confidence: 99%

Bipolar Disorder in Primary Care: Integrated Care Experiences

Cerimele

Kern

2017

FOC

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Primary care clinics are increasingly implementing collaborative care models to care for patients with psychiatric illnesses in primary care. The evidence base for the effectiveness of collaborative care has largely been derived from the care of patients with depression or anxiety disorders, although psychiatrists working in primary care may encounter patients with illnesses other than depression or anxiety disorder, notably bipolar disorder. Patients with bipolar disorder report having received treatment in primary care in equal proportions as those in specialty care settings over the past 12 months, although quality of care is lower in primary care than in specialty care settings. For patients already presenting to primary care, collaborative care is one population-based care model that may increase the proportion of individuals with bipolar disorder who are exposed to high-quality psychiatric care, such as appropriate medication treatment and laboratory monitoring. The primary care setting may even present unexpected strengths in caring for patients with bipolar disorder. Solutions to barriers to expanding the scope of collaborative care to include patients with bipolar disorder may apply to the care of patients with other complex disorders in the primary care setting.

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“…The method of care is also an important factor impacting the outcome of antidepressant treatment. A recent RCT [62] demonstrated that measurement-based care is more feasible and effective than standard treatment (clinicians' choices) for outpatients with moderate to severe MDD. However, evidence from highquality, randomized, double-blinded, placebo-controlled trials in the Chinese population is still lacking.…”

Section: Clinical Treatment Of Mdd Antidepressantsmentioning

confidence: 99%

The Current Situation on Major Depressive Disorder in China: Research on Mechanisms and Clinical Practice

et al. 2016

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Depression is the most disabling disorder worldwide that accounts for the highest proportion of global burden attributable to mental disorders. Major depressive disorder (MDD) is characterized by deep sadness, reduced energy, vegetative nervous system dysregulation, cognitive dysfunction, and even a high suicidal tendency. Although other treatment choices are available, antidepressant medication is the front-line treatment option for MDD. Regarding clinical efficacy, only *50% of patients respond to frontline antidepressants, and \33% obtain remission. Currently, objective indexes to guide clinical decisions are still lacking. Furthermore, knowledge about the neurobiological mechanisms underlying discrepant antidepressant outcomes is still also fragmentary. In the present review, we discuss the current research progress and clinical opinions on MDD in China.

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Measurement-Based Care Versus Standard Care for Major Depression: A Randomized Controlled Trial With Blind Raters

Abstract: The results demonstrate the feasibility and effectiveness of measurement-based care for outpatients with moderate to severe major depression, suggesting that this approach can be incorporated in the clinical care of patients with major depression.

Cited by 238 publications

References 32 publications

The use of PROMs and shared decision‐making in medical encounters with patients: An opportunity to deliver value‐based health care to patients

The use of PROMs and shared decision‐making in medical encounters with patients: An opportunity to deliver value‐based health care to patients

Bipolar Disorder in Primary Care: Integrated Care Experiences

The Current Situation on Major Depressive Disorder in China: Research on Mechanisms and Clinical Practice

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