title: Measurement-based care in psychiatric practice: a policy framework for implementation.
abstract: This article describes the need for measurement-based care (MBC) in psychiatric practice and defines a policy framework for implementation. Although measurement in psychiatric treatment is not new, it is not standard clinical practice. Thus a gap exists between research and practice outcomes. The current standards of psychiatric clinical care are reviewed and illustrated by a case example, along with MBC improvements. Measurement-based care is defined for clinical practice along with limitations and recommendations. This article provides a policy top 10 list for implementing MBC into standard practice, including establishing clear expectations and guidelines, fostering practice-based implementation capacities, altering financial incentives, helping practicing doctors adapt to MBC, developing and expanding the MBC science base, and engaging consumers and their families. Measurement-based care as the standard of care could transform psychiatric practice, move psychiatry into the mainstream of medicine, and improve the quality of care for patients with psychiatric illness.
authors.affiliation: Columbia University, Department of Psychiatry, New York, NY 10032, USA. Kjh2104@columbia.edu
authors.forename: Kelli Jane K
authors.initials: KJ
authors.lastname: Harding
authors.forename: A John
authors.initials: AJ
authors.lastname: Rush
authors.forename: Melissa
authors.initials: M
authors.lastname: Arbuckle
authors.forename: Madhukar H
authors.initials: MH
authors.lastname: Trivedi
authors.forename: Harold Alan
authors.initials: HA
authors.lastname: Pincus
mesh_terms: D000328:Adult; D000928:Antidepressive Agents / Q000009:adverse effects / Q000627:therapeutic use*; D003299:Cooperative Behavior; D003865:Major Depressive Disorder / Q000175:diagnosis / Q000188:drug therapy* / Q000523:psychology; D019468:Disease Management; D000068736:Duloxetine Hydrochloride; D005260:Female; D006284:Health Plan Implementation / Q000458:organization & administration* / Q000592:standards*; D006801:Humans; D033183:Interdisciplinary Communication; D055118:Medication Adherence / Q000523:psychology; D010043:Outcome and Process Assessment, Health Care / Q000592:standards*; D059039:Standard of Care / Q000592:standards*; D011795:Surveys and Questionnaires; D013876:Thiophenes / Q000009:adverse effects / Q000627:therapeutic use*
chemical_list: D000928:Antidepressive Agents; D013876:Thiophenes; D000068736:Duloxetine Hydrochloride