Skip to main content Accessibility help
×
Home

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

  • Stefan Priebe (a1), Rosemarie McCabe (a1), Jens Bullenkamp (a2), Lars Hansson (a3), Wulf Rössler (a4), Francisco Torres-Gonzales (a5) and Durk Wiersma (a6)...

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.

Copyright

Corresponding author

Indirizzo per la corrispondenza: Professor S. Priebe, Barts and the London School of Medicine, Queen Mary, West Smithfield, London EC1A 7BE(UK). E-mail: S.Priebe@qmw.ac.uk

References

Hide All
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, 3442.
Awad, A.G. & Voruganti, L.N.P. (2000). Intervention research in psychosis: issues related to the assessment of quality of life. Schizophrenia Bulletin 26, 557564.
Bertakis, D., Roter, D. & Putnam, S.M. (1991). The relationship of physician medical interview style to patient satisfaction. Journal of Family Practice 32, 175181.
Brill, P.L., Lish, J.D. & Grissom, G.R. (1995). Timing is everything: pre-post versus concurrent measurement. Behavioral Healthcare Tomorrow 4, 7677.
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, 184188.
Burgess, P. & Pirkis, J. (1999). The currency of case management: benefits and costs. Current Opinion in Psychiatry 12, 195199.
Department of Health (1997). The New NHS: Modern, Dependable. Department of Health: London.
Department of Health (1999). The National Service Framework for Mental Health. Department of Health: London..
Ellwood, P.M. (1998). Shattuck lecture – Outcomes management. A technology of patient experience. New England Journal of Medicine 318, 15491556.
Fakhoury, W. & Priebe, S. (2002). The process of deinstitutionalization: an international overview. Current Opinion in Psychiatry 15, 187192.
Frank, A.F. & Gunderson, J.G. (1990). The role of the therapeutic alliance in the treatment of schizophrenia. Archives of General Psychiatry 47, 228236.
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, 190209.
Harrison, G. & Eaton, W.W. (1999). From research world to real world: routine outcome measures are the key. Current Opinion in Psychiatry 12, 187189.
Herrman, H. (2000). Assessing quality of life in people living with psychosis. Epidemiologia e Psichiatria Sociale 9, 16.
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, 276283.
Killian, R. & Angermeyer, M.C. (1999). Quality of life in psychiatry as an ethical duty: from the clinical to the societal perspective. Psychopathology 32, 127134.
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 64,532539.
Lambert, E.W., Doucette, A. & Bickman, L. (2001). Measuring mental health outcomes with pre-post designs. Journal of Behavioural Health Services and Research 28, 273286.
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.
Lehman, A. (1983). The well-being of chronic mental patients. Archives of General Psychiatry 40, 369373.
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, 6772.
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, 908911.
Marks, I. (1998). Overcoming obstacles to routine outcome measurement: the nuts and bolts of implementing clinical audit. British Journal of Psychiatry 173, 281286.
McCabe, R. & Priebe, S. (2002). Focussing on quality of life in treatment. International Review of Psychiatry 14, 225230.
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.
McGuire, R., McCabe, R. & Priebe, S. (2001), Theoretical frameworks for understanding and investigating the therapeutic relationship in psychiatry. Social Psychiatry and Psychiatric Epidemiology 36, 557564,
Neale, M.S. & Rosenheck, R.A. (1995). Therapeutic alliance and outcome in a VA intensive case management programme. Psychiatric Services 46, 719721.
Perkins, R. (2001). What constitutes success? The relative priority of service users' and clincians' views of mental health services. British Journal of Psychiatry 179, 910.
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.
Priebe, S. (2000). Ensuring and improving quality in community mental health care. International Review of Psychiatry 12, 226232.
Priebe, S. & Broker, M. (1999). Prediction of hospitalizations by schizophrenia patients' assessment of treatment: an expanded study. Journal of Psychiatric Research 33, 113119.
Priebe, S. & Gruyters, T. (1995a). Patients' assessment of treatment predicting outcome. Schizophrenia Bulletin 21, 8794
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, 229236.
Priebe, S. & Gruyters, T. (1999). A pilot trial of treatment changes according to schizophrenic patients' wishes. Journal of Nervous and Mental Disease 187, 441443
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, 385392.
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 277,350356.
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, 965974.
Salvador-Carulla, L. (1999). Routine outcome assessment in mental health research. Current Opinion in Psychiatry 12, 207210.
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, 138143.
Shepherd, G., Murray, A. & Muijen, M. (1995). Perspectives on schizophrenia: the views of users, relatives and professionals. Journal of Mental Health 4, 403422.
Slade, M., Thornicroft, G. & Glover, G. (1999). The feasibility of routine outcome measures in mental health. Social Psychiatry and Psychiatric Epidemiology 34, 244250.
Slade, M. (in press). Routine outcome assessment in mental health services. Psychological Medicine.
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, 364368.
Solomon, P., Draine, J. & Delaney, M.A. (1995). The working alliance and consumer case management. Journal of Mental Health Administration 22, 126134.
Stewart, M. (1984). What is a successful doctor-patient interview? A study of interactions and outcomes. Social Science and Medicine 19, 167175.
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 99,281287.
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, 195204.
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, 3341.
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, 165172.
Warner, R. (1999). The emics and etics of quality of life assessment. Social Psychiatry and Psychiatric Epidemiology 34, 117121.

Keywords

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

  • Stefan Priebe (a1), Rosemarie McCabe (a1), Jens Bullenkamp (a2), Lars Hansson (a3), Wulf Rössler (a4), Francisco Torres-Gonzales (a5) and Durk Wiersma (a6)...

Metrics

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed