Use of standardised outcome measures in adult mental health services: randomised controlled trial

Abstract

Background: Routine use of standardised outcome measures is not universal.

Aims: To evaluate the effectiveness of standardised outcome assessment.

Method: A randomised controlled trial, involving 160 representative adult mental health patients and paired staff (ISRCTN16971059). The intervention group (n=101) (a) completed monthly postal questionnaires assessing needs, quality of life, mental health problem severity and therapeutic alliance, and (b) received 3-monthly feedback. The control group (n=59) received treatment as usual.

Results: The intervention did not improve primary outcomes of patient-rated unmet need and of quality of life. Other subjective secondary outcome measures were also not improved. The intervention reduced psychiatric inpatient days (3.5 v.16.4 mean days, bootstrapped 95% CI1.6-25.7), and hence service use costs were 2586 UK pounds (95% CI 102-5391) less for intervention-group patients. Net benefit analysis indicated that the intervention was cost-effective.

Conclusions: Routine use of outcome measures as implemented in this study did not improve subjective outcomes, but was associated with reduced psychiatric inpatient admissions.