Implementing patient-centered decision support for mental health

实施以患者为中心的心理健康决策支持

基本信息

批准号：
8584127
负责人：
Alexander S. Young
金额：
$ 23.1万
依托单位：
UNIVERSITY OF CALIFORNIA LOS ANGELES
依托单位国家：
美国
项目类别：
财政年份：
2013
资助国家：
美国
起止时间：
2013-08-09 至 2015-07-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8584127
关键词：
Adverse effects Affect Area Attention Behavior Cardiovascular Diseases Caring Characteristics Clinic Clinical Cognitive Communities Decision Making Education Enrollment Evaluation Evidence based practice Evidence based treatment Family Feasibility Studies Gambling Goals Guidelines Health Services Accessibility Healthcare Hybrids Individual Intervention Lead Learning Marketing Measures Medical Records Medical center Mental Health Methods Obesity Outcome Overweight Participant Patient Education Patient Preferences Patient-Centered Care Patients Pharmaceutical Preparations Planning Theory Population Premature Mortality Psychiatrist Research Research Personnel Respondent Role Schizophrenia Services Specific qualifier value Supported Employment System Time Training Treatment Effectiveness Visit Weight Weight maintenance regimen Work alternative treatment base computerized design disability evidence base implementation research improved innovation meetings patient oriented point of care preference programs prospective psychosocial public health relevance response satisfaction severe mental illness social treatment program

项目摘要

DESCRIPTION (provided by applicant): Background/Rationale: It is important that patients with serious mental illness have access to treatments that meet their preferences, and make informed choices among alternative treatments. Too often, preferences are not being routinely elicited from patients, nor used to guide which treatments are made available. Schizophrenia is a serious mental illness that is common and can produce substantial disability when poorly treated. National treatment guidelines specify that patients with schizophrenia should receive evidence-based psychosocial treatments that improve outcomes. For example, obesity is a pressing problem in this population, a side-effect of commonly used medications, and a cause of cardiovascular disease and premature mortality. There are multiple, different psychosocial treatments for weight management that can lead to reduced weight. None are widely used. If patient preferences were routinely assessed, then clinicians and managers would know when to make alternative treatments available, and for which patients. Objectives: This project implements and evaluates a method for routinely assessing the treatment preferences of patients with schizophrenia. The objectives are to: 1) develop a computerized, kiosk-based system that delivers patient education regarding treatment options for weight, uses conjoint analysis to elicit patient preferences, and meets the cognitive needs of individuals with schizophrenia; 2) study the feasibility and acceptability of implementing this method at a mental health clinic; and, 3) evaluate the extent to which this method predicts use of an evidence-based weight service, and satisfaction with the service at three months. Methods: This is a prospective evaluation of preferences, treatment use, and satisfaction in patients with schizophrenia. 94 patients are enrolled who are overweight and receiving treatment at a busy, urban mental health clinic. These participants use a kiosk system that provides them with education about treatment options, and assesses their preferences regarding alternative treatments for overweight. They are then offered a weekly, intensive, evidence-based psychosocial treatment for weight. Research assessments occur at baseline and 3 months. Treatment preferences are analyzed to determine how they relate to use of weight treatment, and satisfaction with treatment. Significance: People with serious mental illness could benefit from access to effective psychosocial treatments. Implementing these treatments would be facilitated by routinely collecting information regarding individual patients' preferences. If the assessment method in this study is found to be feasible, acceptable, and accurate, it could be used to support implementation of improved care at clinics, medical centers, and community-based programs.