title: A digital intake approach in specialized mental health care: study protocol of a cluster randomised controlled trial.
abstract: Enhancing patient participation is becoming increasingly important in mental health care as patients use to have a dependent, inactive role and nonadherence to treatment is a regular problem. Research shows promising results of initiatives stimulating patient participation in partnership with their clinicians. However, few initiatives targeting both patients' and clinicians' behaviour have been evaluated in randomised trials (RCT). Therefore, in GGz Breburg, a specialized mental health institution, a digital intake approach was developed aimed at exploring treatment needs, expectations and preferences of patients intended to prepare patients for the intake consultations. Subsequently, patients and clinicians discuss this information during intake consultations and make shared decisions about options in treatment. The aim of this trial is to test the efficacy of this new digital intake approach facilitated by Routine Outcome Monitoring (ROM), peer support and training of clinicians as compared to the intake as usual. The primary outcome is decisional conflict about choices in treatment. Secondary outcomes focus on patient participation, shared decision making, working alliance, adherence to treatment and clinical outcomes.
  
  
  
  This article presents the study protocol of a cluster-randomised controlled trial in four outpatient departments for adults with depression, anxiety and personality disorders, working in two different regions. Randomisation is done between two similar intake-teams within each department. In the four intervention teams the new intake approach is implemented. The four control teams apply the intake as usual and will implement the new approach after the completion of the study. In total 176 patients are projected to participate in the study. Data collection will be at baseline, and at two weeks and two months after the intake.
  
  
  
  This study will potentially demonstrate the efficacy of the new digital intake approach in mental health care in terms of the primary outcome the degree of decisional conflict about choices in treatment. The findings of this study may contribute to the roll out of such eHealth initiatives fostering patient involvement in decision making about their treatment.
  
  
  
  Trial registration: Dutch Trial Register NTR5677 . Registered 17th January 2016.
authors.affiliation: EMGO Institute for Health and Care Research (EMGO+), VU University, Amsterdam, The Netherlands. m.metz@ggzbreburg.nl.|GGz Breburg, Mental Health Institute, Postbus 770, 5000 AT, Tilburg, The Netherlands. m.metz@ggzbreburg.nl.
authors.forename: Margot J
authors.initials: MJ
authors.lastname: Metz
authors.affiliation: GGz Breburg, Mental Health Institute, Postbus 770, 5000 AT, Tilburg, The Netherlands.|School for Public Health and Primary Care (CAPHRI), Maastricht University, Maastricht, Netherlands.|TRANZO Department, Tilburg University, Tilburg, The Netherlands.
authors.forename: Iman
authors.initials: I
authors.lastname: Elfeddali
authors.affiliation: GGz Breburg, Mental Health Institute, Postbus 770, 5000 AT, Tilburg, The Netherlands.
authors.forename: David G H
authors.initials: DG
authors.lastname: Krol
authors.affiliation: Netherlands Institute of Mental Health and Addiction (Trimbos Institute), P.O. Box 725, 3500 AS, Utrecht, The Netherlands.
authors.forename: Marjolein A
authors.initials: MA
authors.lastname: Veerbeek
authors.affiliation: Department of Clinical Psychology, University of Leiden, Leiden, The Netherlands.|Foundation Benchmark Mental Health Care, Stichting Benchmark GGZ, Rembrandtlaan 46, 3723 BK, Bilthoven, The Netherlands.
authors.forename: Edwin
authors.initials: E
authors.lastname: de Beurs
authors.affiliation: Department of Psychiatry, VU University Medical Centre, Amsterdam, The Netherlands.|GGZ inGeest, Mental Health Institute, A.J. Ernststraat 1187, 1081 HL, Amsterdam, The Netherlands.
authors.forename: Aartjan T F
authors.initials: AT
authors.lastname: Beekman
authors.affiliation: GGz Breburg, Mental Health Institute, Postbus 770, 5000 AT, Tilburg, The Netherlands.|TRANZO Department, Tilburg University, Tilburg, The Netherlands.
authors.forename: Christina M
authors.initials: CM
authors.lastname: van der Feltz-Cornelis
mesh_terms: D000328:Adult; D000066491:Clinical Decision-Making / Q000379:methods*; D016000:Cluster Analysis; D003657:Decision Making; D057286:Electronic Health Records; D005260:Female; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis / Q000628:therapy*; D008603:Mental Health; D010358:Patient Participation / Q000379:methods*; D012017:Referral and Consultation; D016037:Single-Blind Method
keywords: Adherence to treatment; Anxiety disorder; Cluster randomised controlled trial; Decisional conflict; Depressive disorder; Intake; Mental health care; Patient participation; Patient preference; Peer support; Personality disorder; Routine Outcome Monitoring; Shared Decision Making; eHealth