Use of standardised outcome measures in adult mental health services: randomised controlled trial.
BACKGROUND
Routine use of standardised outcome measures is not universal.


OBJECTIVE
To evaluate the effectiveness of standardised outcome assessment.


METHODS
A randomised controlled trial, involving 160 representative adult mental health patients and paired staff (ISRCTN16971059). The intervention group (n=101) (a) completed monthly postal questionnaires assessing needs, quality of life, mental health problem severity and therapeutic alliance, and (b) received 3-monthly feedback. The control group (n=59) received treatment as usual.


RESULTS
The intervention did not improve primary outcomes of patient-rated unmet need and of quality of life. Other subjective secondary outcome measures were also not improved. The intervention reduced psychiatric inpatient days (3.5 v.16.4 mean days, bootstrapped 95% CI1.6-25.7), and hence service use costs were 2586 UK pounds (95% CI 102-5391) less for intervention-group patients. Net benefit analysis indicated that the intervention was cost-effective.


CONCLUSIONS
Routine use of outcome measures as implemented in this study did not improve subjective outcomes, but was associated with reduced psychiatric inpatient admissions.
Slade
Mike
M
Health Services Research Department (Box P029), Institute of Psychiatry, King's College London, London SE5 8AF, UK. m.slade@iop.kcl.ac.uk
McCrone
Paul
P
Kuipers
Elizabeth
E
Leese
Morven
M
Cahill
Sharon
S
Parabiaghi
Alberto
A
Priebe
Stefan
S
Thornicroft
Graham
G
D000328:Adult; D005260:Female; D006304:Health Status; D006305:Health Status Indicators; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000628:therapy*; D008605:Mental Health Services / Q000592:standards* / Q000706:statistics & numerical data; D008875:Middle Aged; D017063:Outcome Assessment, Health Care / Q000592:standards*; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data; D011569:Psychiatric Status Rating Scales / Q000592:standards