Saturday, Oct. 29
15:45 – 16:45 (1 hr)
Meeting Room: Cedar (Mezzanine)
Karen Wang*, MD, Med, FRCPC, MSc; Ayan Dey, MD, PhD; David Freedman, MD
- Medical Expert
At the end of this session, participants will be able to: 1) Review research evidence for measurement-based care in clinical settings; 2) Develop an appreciation of the importance of measurement-based care in psychiatry training programs; and 3) Appreciate patient and provider perspectives on measurement-based care.
Measurement-based care (MBC) was introduced as a means of revolutionizing psychiatric care by addressing concerns about the effectiveness of care delivery. MBC is defined as the systematic administration of symptom rating scales to drive clinical decision making and allows for early identification of clinical deterioration, improved clinical accuracy, enhanced individualized treatment, improved patient symptom profile, and reduced response time and remission of major depressive disorder. Despite the evidence that MBC can enhance psychiatric outcomes for patients, the literature on implementation reveals that clinicians have been hesitant to use this approach due to lack of training, perceived time limitations, and institutional barriers (e.g., lack of incentives and leadership support). In this interactive introductory workshop, participants will have an opportunity to enhance their knowledge and understanding of MBC. Participants will review the research on MBC within mental health settings; examine patients’ and providers’ experiences of MBC, and refine their communication skills to convey the principles of MBC to their own patients. This workshop would be appropriate for psychiatry residents and mental health clinicians who have had limited exposure to measurement-based care. Participants will be provided with a toolkit of MBC resources upon completion of the workshop.
W52a – Making Measurement Meaningful: Physician and Patient Experiences of Measurement-Based Care
Ayan Dey, MD, PhD
At the end of this session, participants will be able to: 1) Discuss similarities and differences in physician and patient perspectives on the use, benefits, limitations, and barriers to measurement-based care (MBC); 2) Identify practical strategies to overcome implementation challenges pertaining to physician or patient concerns; and 3) Discuss specific case examples relating to patient and provider experiences.
In this portion of the workshop, we will review existing literature on patient and physician perspectives on the use, benefits, limitations, and barriers to measurement-based care (MBC) in psychiatric populations. This will be integrated with themes gathered from recorded interviews with clinicians and patients newly introduced to MBC. Specifically, we will discuss ways in which clinicians currently use MBC in their practice, the clinical populations it is used in, the measures most often used, as well as perceived barriers and limitations on their use. We will discuss perceptions of the impact of MBC on the patient experience and level of engagement in their care, as well as potential unintended effects.
- Atkinson TM, Schwartz CE, Goldstein L, et al. Perceptions of response burden associated with completion of patient-reported outcome assessments in oncology. Value Health 2019;22:225–30.
- Cuperfain AB, Hui K, Berkhout SG, et al. Patient, family and provider views of measurement-based care in an early-psychosis intervention programme. BJPsych Open 2021;7:e171.
W52b – Making Measurement Integral: Understanding the Science of Measurement-Based Care
Karen Wang, Med, MD, FRCPC, MSc
At the end of this session, participants will be able to: 1) Review the evidence base for the effectiveness of measurement-based care (MBC) in clinical settings; 2) Understand the importance of appropriate patient rating scale selection in MBC; and 3) Analyze various patient rating scales for different diagnostic categories and their indications for use.
In this segment of the workshop, we will review the literature that supports the use of measurement-based care (MBC) in clinical settings. We will identify seminal studies, including randomized controlled trials (RCTs) and systematic reviews, that showcase the benefits and challenges of implementing MBC for common psychiatric disorders, such as major depression. A key component of this segment will be highlighting the unique features of different patient rating scales and their clinical applications in various populations.
- Fortney JC, Unützer J, Wrenn G, et al. A tipping point for measurement-based care. Psychiatr Serv 2017;68:179–88.
- Tong G, Xiang Y-T, Xiao L, et al. Measurement-based care versus standard care for major depression: a randomized controlled trial with blind raters. Am J Psychiatry 2015;172:1004–13.
W52c – Making Measurement Sustainable: Measurement-Based Care Training in Mental Health Settings
David Freedman, MD
At the end of this session, participants will be able to: 1) Develop an appreciation of the importance of measurement-based care (MBC) in psychiatry training programs to ensure sustainability of MBC; 2) Understand the SIGNAL framework to enhance communication around MBC with patients; and 3) Apply the SIGNAL framework to specific patient case examples.
Educating trainees is fundamental to expanding the practice of measurement-based care (MBC) among psychiatrists. Yet, in a complex academic and clinical environment with competing priorities, it is challenging for clinicians to design effective and sustainable MBC curricula. Grounded in a review of the available literature, we will introduce participants to a framework for MBC training. During the session, participants have opportunities to apply this framework to their local institutions, learning skills to support MBC curriculum creation and enhance their communication around MBC with patients.
- Peterson AP, Fagan C. Training the next generation in routine outcome monitoring: current practices in psychology training clinics. Train Educ Prof Psychol 2017;11:182–9.
- Freedman DE, Waddell AE, Bourdon A, et al. Educating trainees about measurement based care: a scoping review. Manuscript in preparation.