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The study of the outcome of clinical interventions is an important area of clinical research for a number of reasons.
Examples of potential uses for outcome measures include:
- To help clinicians answer the question of whether a user is responding to the treatment they are being offered
- To contribute to the quality evaluation of individual clinicians’ practice, as part of continuing professional development and performance review.
- To evaluate the extent to which measured change in a user is clinically significant – i.e. change that makes a difference to the everyday lives of users and is not just statistically significant
- To compare outcomes between similar services (e.g. psychological therapy services provided to outpatients as part of a Community Mental Health Team or services for people with learning difficulties; counselling services in primary care; family therapy services for children) in different areas.
- To compare outcomes between individual clinicians working in the same service, in order to see if they are achieving comparable results.
- To compare outcomes between different user groups within the same service; for example, is the service achieving better outcomes for users with depression
than those with anxiety or with white users than with those from ethnic minority groups?
- As a pointer to the need for further investigation or action as part of a quality improvement process.
- To contribute to performance monitoring and audit of a service.
- To provide feedback to a service about the course of response (recovery or deterioration) of those receiving help.
- To provide information for the development of practice-based evidence, to help to build up a picture of the effectiveness of various therapeutic approaches with the range and diversity of problems found in routine clinical practice.
- To provide purchasers of services with data on efficacy and efficiency of therapy services.
- To help purchasers evaluate different therapetic orientations with regard to efficiency and effectiveness.
(List developed from Sperlinger, 2002)
Factors effecting outcome
A number of factors can effect therapy outcome:
- Spontaneous remission
- Client variables in determining clinical outcome
- Therapist variables in determining clinical outcome
Assessment of outcome in psychological thearapy
- Assessment of outcome in psychological therapy
- Routine outcome measurement
- Staff attitudes to clinical outcome assessment
See also
References & Bibliography
Key texts
Books
- Thornicroft, G. & Tansella, M. (1996)(eds) Mental Health Outcome Measures. Berlin: Springer
Papers
- Andrews, G., et al. (1994) The measurement of consumer outcome in mental health.
Sydney: Clinical Research Unit for Anxiety Disorders
- Berger, M. (1996) Outcomes and effectiveness in clinical practice. Leicester: British Psychological Society
Clifford, P. (1998) M is for outcome. Journal of Mental Health, 7, 19-24
- Fitzpatrick, F., Davey, C., Buxton, M., and Jones, D. (1998) Evaluating patient-based outcome measures for use in clinical trials. Health Technology Assessment, 2, 14
- Froyd, J., Lambert, M., and Froyd, J. (1996) A review of practices of psychotherapy outcome measurement. Journal of Mental Health, 5, 11-15
- Huxley, P. (1998) Outcomes management in mental health. Journal of Mental Health, 7, 273-283
- Ruggeri, M. (1996) Satisfaction with psychiatric services. In G. Thornicroft and M. Tansella (eds) Mental Health Outcome Measures. Berlin: Springer
- Slade, M., Thornicroft, G. and Glover, G. (1999) The feasibility of routine outcome measures in mental health. Social Psychiatry and Psychiatric Epidemiology, 34, 243-249
- Stedman, T., Yellowlees, P., Mellsop, G., Clarke, R., and Drake, S. (1997) Measuring consumer outcomes in mental health. Canberra: Department of Health and Family Services
- Wolpert, M., Wilkinson, I., and Fuggle, P. (2001) Minimum standards for evaluating outcome in clinical practice. Leicester: British Psychological Society (DCP
Children & Young People SIG)