Standardized Assessment in Depression Treatment in Routine Psychiatric Services: a Retrospective Medical Record Review
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 入组人数
- 2,173
- 试验地点
- 1
- 主要终点
- Montgomery-Åsberg Depression Rating Scale
研究概览
简要总结
The goal of this observational study is to evaluate current practices in depression treatment in psychiatric services in Stockholm, Sweden.
The main questions it aims to answer are:
- Are current practices consistent with local clinical guidelines in terms of standardized assessment and the treatments provided?
- What are the present conditions for implementing measurement-based care in depression treatment in this setting?
Data will be collected retrospectively from medical records of patients having received psychological or pharmacological treatment for depression from 2020 to 2023. Frequency of standardized assessments (not scores) using the Montgomery-Åsberg Depression Rating Scale, the Montgomery-Åsberg Depression Rating Scale-Self Assessment, and the Patient Health Questionnaire-9 is collected, together with information on patient, clinician, and treatment characteristics.
详细描述
Measurement-based care (MBC) refers to assessing outcomes prior to and during treatment with the purpose of providing a basis for treatment decisions and planning as treatment progresses (Lewis et al., 2019). MBC typically involves routine outcome monitoring on a session-to-session basis and clinical support tools to aid in the treatment process (Scott & Lewis, 2015; Trivedi, 2020). Research shows that MBC improves outcomes om symptom measures and reduces dropout as compared to treatment as usual without MBC (de Jong et al., 2021; Rognstad et al., 2023). Central to MBC is the frequent and systematic administration of outcome measures.
In public psychiatric services in Stockholm, Sweden, local clinical guidelines of the assessment and treatment of depression have been developed (Region Stockholm, 2021). These guidelines specify what psychological and pharmacological treatments to use, and at what time intervals assessment of outcomes should be conducted, and what measures to use. However, adherence to these guidelines in clinicians have not been evaluated; thus, it is not known to what extent the guidelines are properly implemented and what the present conditions are for introducing MBC in depression treatment in this setting.
Aims and research questions
A first aim of this study is to evaluate current practices in depression treatment in public psychiatric services in Stockholm. A second aim is to assess to what extent these practices adhere to local clinical guidelines, and if practices vary according to patient, clinician, and treatment characteristics. A third aim is to assess the present conditions for implementing MBC in depression treatment in this setting. The second aim provides valuable information for future initiatives of improving the conditions for implementing MBC in routine clinical practice settings. Research questions include:
- Are current practices consistent with local clinical guidelines in terms of standardized assessment and the treatments provided?
- Do current practices vary with patient, clinician, and treatment characteristics?
- What are the present conditions for implementing MBC in depression treatment in this setting?
研究设计
- 研究类型
- Observational
- 观察模型
- Cohort
- 时间视角
- Retrospective
入排标准
- 年龄范围
- 18 Years 至 —（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •18 years of age or older
- •Principal diagnosis of major depressive disorder
- •Psychological or pharmacological treatment initiated and completed between 1 January 2020 and 30 September 2023 at one of five general psychiatric clinics within public psychiatric outpatient services in Stockholm, Sweden
排除标准
- 未提供
结局指标
主要结局
Montgomery-Åsberg Depression Rating Scale
时间窗: Through study completion, an average of 1 year
Ten-item clinician-administered measure of depressive symptoms
次要结局
- The Patient Health Questionnaire-9(Through study completion, an average of 1 year)
- Montgomery-Åsberg Depression Rating Scale-Self Assessment(Through study completion, an average of 1 year)
研究者
Benjamin Bohman
Associate professor
Karolinska Institutet