To determine the effects of feedback regarding patient progress on patient outcome and number of treatment sessions. Questions are::1, Is monitoring with feedback to therapists more (cost-)effective than monitoring without feedback; 2, is feedback…
ID
Source
Brief title
Condition
- Other condition
Synonym
Health condition
Uiteenlopende psychiatrische aandoeningen (As-I, As-II, DSM-IV).
Research involving
Sponsors and support
Intervention
Outcome measures
Primary outcome
OQ-45 (symptoms); TiC-P (direct medical costs and production losses);
EuroQol-5D (health status index). The cost-effectiveness of the interventions
will be examined by linking costs of the intervention, treatments, direct
medical costs and costs of production losses to the number of sessions until
clinical significant and reliable change. For cost-utility analysis, QALY's
will be used (EuroQOL-5D).
Secondary outcome
The following patient variables will be registered once, at the beginning of
treatment: sex, age, marital status, SES (education, work/study), cultural
background, psychiatric classification (Axis-I, Axis-II, Axis-V). The Helping
Alliance Questionnaire-19 will be administerd before sessions 3, 4, and 5 (3
minutes).
Background summary
The high cost, common occurrence and rapid growth of psychotherapy are reasons
for concern in mental health policy (Health Council of the Netherlands, 2001).
Although scientifically informing clinical practice may be helpful in improving
quality of care, many clinical problems cannot be solved by this means. In
contrast, monitoring with feedback has the advantage of focusing directly on
enhancing
cost-efficiency in all patients, regardless of diagnosis and treatment. To
date, some answers to the question regarding the effectiveness of monitoring
were given in three studies showing that monitoring with feedback to therapists
results in efficiency gains. The effects of feedback to both therapists and
patients have been studied in one investigation These studies were conducted on
very brief treatments (mean = 7 sessions). In the Netherlands, no data is
available that shows the rate of change in health status of clients from one
psychotherapeutic session to the other. It is also unknown how many sessions
are needed in order to produce clinical significant changes, let alone how this
relates to diagnostic categories. Last, it is unknown whether treatment
duration and treatment effects will improve by giving therapists (and patients)
feedback on patient progress on a session by session basis.
Study objective
To determine the effects of feedback regarding patient progress on patient
outcome and number of treatment sessions.
Questions are::
1, Is monitoring with feedback to therapists more (cost-)effective than
monitoring without feedback; 2, is feedback to therapists and patients more
(cost-)effective than feedback to therapists alone?
Study design
RCT parallel group design, comparing the outcome of patients randomized to
feedback to therapist, feedback to both therapist and patient, and no feedback.
Patients from the three condtions will be divided a posteriori into those
predicted to be treatment failures (not on track, 33%), and those having a
positive response to therapy (on track, 67%).
Intervention
Feedback consists of weekly progress graphs and messages, tailored to the
status of patients.
Study burden and risks
Subjects will fill in the Outcome Questionnaire-45 on a weekly basis (or less
often, depending on the frequency of sessions). This appears to take 5 minutes.
Apart from this, subjects will fill in the EuroQol-5D and the Tic-P, once per
month during the first three months , and once every three months thereafter
during the treatment period. The EuroQol-5D takes 1 minute and the TiC-P 15
minutes.
Lastly, subject will fill in the Helping Alliance Questionnaire-19 before
sessions 3, 4, and 5 (3 minutes).
The burden is taken to be low, because patients do not perform any other
activities but filling in the questionnaires on line, in a quiet place, near
the office of the therapist (in or near to the waiting-room, in a protected
environment).
Postbus 2040
3000 CA Rotterdam
NL
Postbus 2040
3000 CA Rotterdam
NL
Listed location countries
Age
Inclusion criteria
Age >= 18 years; able to read and write Dutch; willing to accept randomization.
Exclusion criteria
None
Design
Recruitment
Followed up by the following (possibly more current) registration
No registrations found.
Other (possibly less up-to-date) registrations in this register
No registrations found.
In other registers
| Register | ID |
|---|---|
| CCMO | NL11529.078.06 |