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Outcomes measurement in psychiatry: a critical review of outcomes measurement in psychiatric research and practice

Gilbody, S.M., House, A.O. and Sheldon, T.A. (2003) Outcomes measurement in psychiatry: a critical review of outcomes measurement in psychiatric research and practice. Research Report. CRD Report (24). NHS Centre for Reviews and Dissemination , York, UK.

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Abstract

BACKGROUND

Outcomes are measured to establish what works, in the context of evaluative research, and to improve the quality of care that is offered. Traditional outcomes focus upon biomedical endpoints, but there is an increased interest in patient based outcomes, which measure the impact of illness or healthcare interventions on the individual and how they live their day-today life. There are reasons to expect that the application of patient based outcomes would be especially relevant to the discipline of psychiatry.

AIMS

To explore the measurement of outcome in psychiatric research and practice, with particular reference to patient based outcomes.

METHODS

1. A critical literature review of the outcomes movement in health care.

2. A survey and systematic review of the methods used to measure outcome in evaluative psychiatric research (randomised trials and outcomes research).

3. A survey of the use of outcomes measures by UK psychiatrists in their day-to-day practice.

4. A systematic review of the effectiveness of routine outcomes measurement in improving the quality of care for those with common psychiatric disorders.

RESULTS

An outcomes movement has emerged in healthcare, which can be understood in social, political and economic terms. Outcomes measurement in psychiatric research is dominated by the measurement of psychiatric symptoms, with little reference to patient based measures. Practising UK psychiatrists rarely measure outcomes. There are substantial practical and attitudinal barriers to the use of outcomes instruments in NHS mental health services. There is little evidence to support the potential for routine outcomes measures to improve the quality of mental healthcare.

DISCUSSION

Current mental health policy places great emphasis on the measurement of outcomes, and is likely to fail. The potential for patient based outcomes to be adopted in psychiatric research and practice has yet to be realised. The need for important research into the suitability and value of patient based outcomes measures in mental health research and practice is identified.

Item Type: Monograph (Research Report)
Copyright, Publisher and Additional Information: © 2003 NHS Centre for Reviews and Dissemination, University of York. Available from the CRD web site.
Academic Units: The University of York > Centre for Reviews and Dissemination (York)
The University of Leeds > Faculty of Medicine and Health (Leeds) > Institute of Health Sciences (Leeds) > Academic Unit of Psychiatry and Behavioural Sciences (Leeds)
The University of York > Health Sciences (York)
Depositing User: Repository Officer
Date Deposited: 11 Apr 2006
Last Modified: 14 Nov 2008 17:05
Published Version: http://www.york.ac.uk/inst/crd/crdreports.htm
Status: Published
Publisher: NHS Centre for Reviews and Dissemination
Refereed: Yes
Identification Number: Centre for Reviews and Dissemination Report 24
Related URLs:
URI: http://eprints.whiterose.ac.uk/id/eprint/1157

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