title: Effectiveness of the implementation of guidelines for anxiety disorders in specialized mental health care.
abstract: OBJECTIVE
  To examine the effect of implementing anxiety disorders guidelines on guideline adherence and patient outcomes in specialized mental health care.
  
  
  METHODS
  A treatment setting in which guidelines were implemented (intervention condition) was compared with one in which guidelines were only disseminated (control condition).
  
  
  RESULTS
  Of 61.7% of 81 intervention-condition patients received treatment according to the guidelines vs. 40.6% of 69 control-condition patients (P = 0.01). At 1-year follow-up, intervention-condition patients showed a greater decrease in anxiety symptoms (d = 0.48, P < 0.05); higher percentages of response (52.6% vs. 33.8%; P = 0.025) and remission (33.3% vs.16.9%; P = 0.026); and a greater decrease in the rate of phobic avoidance (d = 0.34, P < 0.05). At 2-year follow-up, control-condition patients had experienced a longer period of treatment, which had eroded most of these differences, except for phobic avoidance.
  
  
  CONCLUSIONS
  Systematic guideline implementation results in earlier gains and shorter treatment times.
authors.affiliation: HSK Group, Arnhem and Department of Psychiatry, VU University Medical Centre and GGZinGeest, Amsterdam, the Netherlands.
authors.forename: M K
authors.initials: MK
authors.lastname: van Dijk
authors.affiliation: Department of Psychiatry, UMC St. Radboud and Pro Persona Overwaal, Nijmegen, the Netherlands.
authors.forename: D B
authors.initials: DB
authors.lastname: Oosterbaan
authors.affiliation: Behavioural Science Institute, Radboud University Nijmegen and HSK Group, Arnhem, the Netherlands.
authors.forename: M J P M
authors.initials: MJ
authors.lastname: Verbraak
authors.affiliation: Department of Psychiatry and EMGO+ Institute for Health and Care Research, VU University Medical Centre and GGZinGeest, Amsterdam, the Netherlands.
authors.forename: A W
authors.initials: AW
authors.lastname: Hoogendoorn
authors.affiliation: Department of Psychiatry and EMGO+ Institute for Health and Care Research, VU University Medical Centre and GGZinGeest, Amsterdam, the Netherlands.
authors.forename: B W J H
authors.initials: BW
authors.lastname: Penninx
authors.affiliation: Department of Psychiatry and EMGO+ Institute for Health and Care Research, VU University Medical Centre and GGZinGeest, Amsterdam, the Netherlands.
authors.forename: A J L M
authors.initials: AJ
authors.lastname: van Balkom
mesh_terms: D000328:Adult; D000928:Antidepressive Agents / Q000627:therapeutic use; D001008:Anxiety Disorders / Q000628:therapy*; D001521:Behavior Therapy / Q000379:methods; D016022:Case-Control Studies; D015331:Cohort Studies; D005260:Female; D019983:Guideline Adherence / Q000706:statistics & numerical data*; D006284:Health Plan Implementation / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008605:Mental Health Services / Q000458:organization & administration*; D017410:Practice Guidelines as Topic; D016896:Treatment Outcome
chemical_list: D000928:Antidepressive Agents
keywords: anxiety; health-care services; outcome; treatment