Guidelines improve patient outcomes in specialised mental health care: A systematic review and meta‐analysis.
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| Title: | Guidelines improve patient outcomes in specialised mental health care: A systematic review and meta‐analysis. |
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| Authors: | Setkowski, Kim (AUTHOR), Boogert, Kelly (AUTHOR), Hoogendoorn, Adriaan W. (AUTHOR), Gilissen, Renske (AUTHOR), van Balkom, Anton J. L. M. (AUTHOR) |
| Source: | Acta Psychiatrica Scandinavica. Sep2021, Vol. 144 Issue 3, p246-258. 13p. 2 Diagrams, 3 Graphs. |
| Subjects: | Mental health services, Tau proteins, Mental illness |
| Abstract: | Objective: The uptake of evidence‐based guideline recommendations appears to be challenging. In the midst of the discussion on how to overcome these barriers, the question of whether the use of guidelines leads to improved patient outcomes threatens to be overlooked. This study examined the effectiveness of evidence‐based guidelines for all psychiatric disorders on patient health outcomes in specialist mental health care. All types of evidence‐based guidelines, such as psychological and medication‐focused guidelines, were eligible for inclusion. Provider performance was measured as a secondary outcome. Time to remission when treated with the guidelines was also examined. Method: Six databases were searched until 10 August 2020. Studies were selected, and data were extracted independently according to the PRISMA guidelines. Random effects meta‐analyses were used to pool estimates across studies. Risk of bias was assessed according to the Cochrane Effective Practice and Organization of Care Review Group criteria. PROSPERO:CRD42020171311. Results: The meta‐analysis included 18 studies (N = 5380). Guidelines showed a positive significant effect size on the severity of psychopathological symptoms at the patient level when compared to treatment‐as‐usual (TAU) (d = 0.29, 95%‐CI = (0.19, 0.40), p < 0.001). Removal of a potential outlier gave globally the same results with Cohen's d = 0.26. Time to remission was shorter in the guideline treatment compared with TAU (HR = 1.54, 95%‐CI = (1.29, 1.84), p = 0.001, n = 3). Conclusions: Patients cared for with guideline‐adherent treatments improve to a greater degree and more quickly than patients treated with TAU. Knowledge on the mechanisms of change during guideline‐adherent treatment needs to be developed further such that we can provide the best possible treatment to patients in routine care. [ABSTRACT FROM AUTHOR] |
| Copyright of Acta Psychiatrica Scandinavica is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.) | |
| Database: | Psychology and Behavioral Sciences Collection |
| FullText | Links: – Type: pdflink Text: Availability: 0 |
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| Header | DbId: pbh DbLabel: Psychology and Behavioral Sciences Collection An: 151931915 AccessLevel: 6 PubType: Academic Journal PubTypeId: academicJournal PreciseRelevancyScore: 0 |
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| Items | – Name: Title Label: Title Group: Ti Data: Guidelines improve patient outcomes in specialised mental health care: A systematic review and meta‐analysis. – Name: Author Label: Authors Group: Au Data: <searchLink fieldCode="AR" term="%22Setkowski%2C+Kim%22">Setkowski, Kim</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Boogert%2C+Kelly%22">Boogert, Kelly</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Hoogendoorn%2C+Adriaan+W%2E%22">Hoogendoorn, Adriaan W.</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Gilissen%2C+Renske%22">Gilissen, Renske</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22van+Balkom%2C+Anton+J%2E+L%2E+M%2E%22">van Balkom, Anton J. L. M.</searchLink> (AUTHOR) – Name: TitleSource Label: Source Group: Src Data: <searchLink fieldCode="JN" term="%22Acta+Psychiatrica+Scandinavica%22">Acta Psychiatrica Scandinavica</searchLink>. Sep2021, Vol. 144 Issue 3, p246-258. 13p. 2 Diagrams, 3 Graphs. – Name: Subject Label: Subjects Group: Su Data: <searchLink fieldCode="DE" term="%22Mental+health+services%22">Mental health services</searchLink><br /><searchLink fieldCode="DE" term="%22Tau+proteins%22">Tau proteins</searchLink><br /><searchLink fieldCode="DE" term="%22Mental+illness%22">Mental illness</searchLink> – Name: Abstract Label: Abstract Group: Ab Data: Objective: The uptake of evidence‐based guideline recommendations appears to be challenging. In the midst of the discussion on how to overcome these barriers, the question of whether the use of guidelines leads to improved patient outcomes threatens to be overlooked. This study examined the effectiveness of evidence‐based guidelines for all psychiatric disorders on patient health outcomes in specialist mental health care. All types of evidence‐based guidelines, such as psychological and medication‐focused guidelines, were eligible for inclusion. Provider performance was measured as a secondary outcome. Time to remission when treated with the guidelines was also examined. Method: Six databases were searched until 10 August 2020. Studies were selected, and data were extracted independently according to the PRISMA guidelines. Random effects meta‐analyses were used to pool estimates across studies. Risk of bias was assessed according to the Cochrane Effective Practice and Organization of Care Review Group criteria. PROSPERO:CRD42020171311. Results: The meta‐analysis included 18 studies (N = 5380). Guidelines showed a positive significant effect size on the severity of psychopathological symptoms at the patient level when compared to treatment‐as‐usual (TAU) (d = 0.29, 95%‐CI = (0.19, 0.40), p < 0.001). Removal of a potential outlier gave globally the same results with Cohen's d = 0.26. Time to remission was shorter in the guideline treatment compared with TAU (HR = 1.54, 95%‐CI = (1.29, 1.84), p = 0.001, n = 3). Conclusions: Patients cared for with guideline‐adherent treatments improve to a greater degree and more quickly than patients treated with TAU. Knowledge on the mechanisms of change during guideline‐adherent treatment needs to be developed further such that we can provide the best possible treatment to patients in routine care. [ABSTRACT FROM AUTHOR] – Name: AbstractSuppliedCopyright Label: Group: Ab Data: <i>Copyright of Acta Psychiatrica Scandinavica is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.) |
| PLink | https://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=pbh&AN=151931915 |
| RecordInfo | BibRecord: BibEntity: Identifiers: – Type: doi Value: 10.1111/acps.13332 Languages: – Code: eng Text: English PhysicalDescription: Pagination: PageCount: 13 StartPage: 246 Subjects: – SubjectFull: Mental health services Type: general – SubjectFull: Tau proteins Type: general – SubjectFull: Mental illness Type: general Titles: – TitleFull: Guidelines improve patient outcomes in specialised mental health care: A systematic review and meta‐analysis. Type: main BibRelationships: HasContributorRelationships: – PersonEntity: Name: NameFull: Setkowski, Kim – PersonEntity: Name: NameFull: Boogert, Kelly – PersonEntity: Name: NameFull: Hoogendoorn, Adriaan W. – PersonEntity: Name: NameFull: Gilissen, Renske – PersonEntity: Name: NameFull: van Balkom, Anton J. L. M. IsPartOfRelationships: – BibEntity: Dates: – D: 01 M: 09 Text: Sep2021 Type: published Y: 2021 Identifiers: – Type: issn-print Value: 0001690X Numbering: – Type: volume Value: 144 – Type: issue Value: 3 Titles: – TitleFull: Acta Psychiatrica Scandinavica Type: main |
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