The Importance of Measurement Based Care in Psychiatry
Measurement based care (MBC) is the systematic administration of validated patient-reported outcomes, such as symptom rating scales, and the use of the results to drive clinical decision making at the level of the individual patient. It is becoming the standard of practice for behavioral health care, allowing practices to provide objective evidence that a care plan is working.
MBC is an integral part of routine clinical medicine, such as blood pressure monitoring and hemoglobin A1C tracking, as they help physicians and patients understand their progress over time, identify areas for improvement, and improve overall quality of care. In psychiatry, MBC has been slow to integrate into routine practice, but the use of outcome measures is rapidly increasing.
Unlike bloodwork, the standard measurement for mental health is symptom rating scales, which are brief, sensitive, and reliable. These tools are often used at the start of treatment to measure a client’s baseline symptoms and progress over time, which can aid in individualized care and help clinicians track changes to treatment plans.
According to a recent study published in JAMA Psychiatry, less than one-fifth of mental health providers utilize MBC as their primary method of tracking progress. This means that the majority of therapists are not measuring outcomes on a regular basis, and it could be contributing to poor patient and practitioner outcomes.
In addition to empowering clinicians to focus on individual needs, MBC helps patients become more vested in their treatment. This makes them more likely to see their efforts pay off. It also allows providers to spot when their patient is not responding to treatment and provide them with better support.
Using MBC can help reduce relapse rates by identifying patients who are not benefiting from treatment and providing them with more focused, effective care. It can also increase engagement among patients, reducing drop-out rates and improving treatment outcomes.
A growing body of research demonstrates the efficacy and safety of MBC, which can be implemented in a number of ways to optimize therapist and patient care. These methods include asynchronous feedback, which involves collecting symptom scores periodically and then feeding them back to the provider outside of the therapy session.
Frequent and timely feedback, which is the most successful approach, can also improve therapist and patient outcomes by identifying those who are not responding to treatment and supporting them with evidence-based interventions. These methods have been found to reduce relapses by a significant amount, particularly in psychotherapy.
In order to achieve these benefits, MBC must be facilitated and administered in a consistent way across the entire care team, with accurate data collected, reported and analyzed on an ongoing basis. This may require the development of measurement feedback systems, leveraging local champions, forming learning collaboratives, training leadership, improving expert consultation with clinical staff, and generating incentives.