Measurement-Based Care in Integrated Health Care: A Randomized Clinical Trial

Barry L. Duncan, Robert J. Reese, Alexander J. Lengerich, Brian DeSantis, Cassie V. Comeau, Yajaira Johnson-Esparza

Research output: Contribution to journalArticlepeer-review

2 Scopus citations

Abstract

Introduction: Many suggest that the next step for integrated care is widespread implementation of measurement-based care (MBC). Although the measures most associated with MBC are standardized, no randomized clinical trial has demonstrated their use to improve psychotherapeutic outcomes with embedded behavioral health providers in integrated care. Two evidence-based MBC systems have been studied in a variety of behavioral health environments, but neither system has been investigated in integrated health care. Addressing this gap in the literature, the present study evaluated the use of MBC, specifically the Partners for Change Outcome Management System, in three integrated care sites. Method: Using a randomized design within routine care, treatment as usual (TAU; n = 133) was compared using the Outcome Rating Scale (ORS) and Patient Health Questionnaire–9 (PHQ–9) with a feedback condition (n = 147) in which behavioral health providers had access to patientgenerated outcome (ORS only) and alliance information at each session. Results: Patients in the feedback condition demonstrated significantly more improvement than those in the TAU condition posttreatment on the ORS. Patients in the feedback condition also achieved significantly more clinically significant change as measured by both the ORS and PHQ–9. Feedback condition patients also attended significantly more sessions and dropped out significantly less that TAU patients. Discussion: Although our findings need to be replicated, this study offers evidence that the improved outcomes and reduced dropouts associated with MBC in traditional behavioral health centers also occur in integrated care settings

Original languageEnglish (US)
Pages (from-to)259-268
Number of pages10
JournalFamilies, Systems and Health
Volume39
Issue number2
DOIs
StatePublished - 2021
Externally publishedYes

Keywords

  • Integrated care
  • Measurement-based care (mbc)
  • Partners for change outcome management system (pcoms)
  • Patient feedback
  • Routine outcome monitoring (rom)

ASJC Scopus subject areas

  • Applied Psychology
  • Psychiatry and Mental health

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