nach oben

vorheriger Artikel Versorgungsmodelle der Konsiliar-Liaison-Psychi...

nächster Artikel Elektronische Erhebung von Behandlungsergebniss...

Tipp

Elektronisches Routine-Outcome-Monitoring (eROM) in Psychiatrie und klinischer Psychologie

eROM-Implementierungsbeispiel an der Universitätsklinik für Psychiatrie II in Innsbruck

Zeitschrift:: psychopraxis. neuropraxis > Sonderheft 1/2018

Autoren:: Mag. Jonas Egeter, Lisa M. Wintner, Nathalie Huber, Gerhard Rumpold, Barbara Sperner-Unterweger, Harald R. Bliem, Bernhard Holzner

» Zum Volltext PDF-Version jetzt herunterladen

Zusammenfassung

Selbstberichte von Patienten („patient-reported outcomes“, PROs) ermöglichen eine systematische Sammlung, Auswertung und Dokumentation von Patientenangaben. Sie rücken die Sichtweise der Patienten in den Mittelpunkt und ermöglichen so individualisierte Behandlungsentscheidungen.

An der Station für Psychosomatische Medizin der Medizinischen Universität Innsbruck wurde in vier Schritten ein elektronisches Routine-Outcome-Monitoring (eROM) implementiert. Alle Patienten, die die Einschlusskriterien erfüllten, wurden ab Juni 2015 in das Programm eingeschlossen und bearbeiteten ein vorgegebenes Set von PRO-Instrumenten.

Von Juni 2015 bis Mai 2018 wurden 300 Patienten im Rahmen ihres stationären Aufenthaltes in das eROM eingeschlossen. Die Erhebung wird am Beispielverlauf der ersten routinemäßig befragten Patientin beschrieben, der sich über drei stationäre Aufenthalte erstreckte.

Das implementierte eROM ist eine praktikable Methode, um standardisiert PRO-Daten im Längsschnitt zu erheben und diese für die individuelle Behandlung zu nutzen. Des Weiteren können diese Daten auch auf Kollektivebene für wissenschaftliche Zwecke ausgewertet werden.

Federal Drug Administration, US Department of Health and Human Services, Guidance for Industry. Patient-reported outcome measures: use in medical product development to support labeling claims, Clin. Fed. Regist. (2009) 1–39. http://www.fda.gov/downloads/Drugs/Guidances/UCM193282.pdf (accessed November 16, 2016).

Cella D, Yount S, Rothrock N, Gershon R, Cook K, Reeve B, Ader D, Fries JF, Bruce B, Rose M, PROMIS Cooperative Group (2007) The patient-reported outcomes measurement information system (PROMIS). Med Care 45:S3–S11. https://doi.org/10.1097/01.mlr.0000258615.42478.55 CrossRefPubMedPubMedCentral

Khanna D, Maranian P, Rothrock N, Cella D, Gershon R, Khanna PP, Spiegel B, Furst DE, Clements PJ, Bechtel A, Hays RD (2012) Feasibility and construct validity of PROMIS and “legacy” instruments in an academic scleroderma clinic. Value Health 15:128–134. https://doi.org/10.1016/j.jval.2011.08.006 CrossRefPubMed

Webster K, Cella D, Yost K (2003) The functional assessment of chronic illness therapy (FACIT) measurement system: properties, applications, and interpretation. Health Qual Life Outcomes 1:79. https://doi.org/10.1186/1477-7525-1-79 CrossRefPubMedPubMedCentral

Aaronson NK, Ahmedzai S, Bergman B, Bullinger M, Cull A, Duez NJ, Filiberti A, Flechtner H, Fleishman SB, De Haes CJM, Kaasa S, Klee M, Osoba D, Razavi D, Rofe B, Schraub S, Sneeuw K, Sullivan M, Takeda F (1993) The European organization for research and treatment of cancer QLQ-C30: a quality-of-life instrument for use in international clinical trials in oncology. J Natl Cancer Inst 85:365–376 CrossRef

Wintner LM, Sztankay M, Aaronson N, Bottomley A, Giesinger JM, Groenvold M, Petersen MA, van de Poll-Franse L, Velikova G, Verdonck-de Leeuw I, Holzner B, EORTC Quality of Life Group (2016) The use of EORTC measures in daily clinical practice—a synopsis of a newly developed manual. Eur J Cancer 68:73–81. https://doi.org/10.1016/j.ejca.2016.08.024 CrossRefPubMed

Hellerstein DJ, Stewart JW, McGrath PJ, Deliyannides DA, Batchelder ST, Black SR, Withers A, O’Shea D, Chen Y (2012) A randomized controlled trial of duloxetine versus placebo in the treatment of nonmajor chronic depression. J Clin Psychiatry 73:984–991. https://doi.org/10.4088/JCP.11m07230 CrossRefPubMed

Arnold LM, Clauw D, Wang F, Ahl J, Gaynor PJ, Wohlreich MM (2010) Flexible dosed duloxetine in the treatment of fibromyalgia: a randomized, double-blind, placebo-controlled trial. J Rheumatol 37:2578–2586. https://doi.org/10.3899/jrheum.100365 CrossRefPubMed

Nickel MK, Muehlbacher M, Nickel C, Kettler C, Gil FP, Bachler E, Buschmann W, Rother N, Fartacek R, Egger C, Anvar J, Rother WK, Loew TH, Kaplan P (2006) Aripiprazole in the treatment of patients with borderline personality disorder: a double-blind, placebo-controlled study. Am J Psychiatry 163:833–838. https://doi.org/10.1176/ajp.2006.163.5.833 CrossRefPubMed

10.

Heldt E, Blaya C, Isolan L, Kipper L, Teruchkin B, Otto MW, Fleck M, Manfro GG (2006) Quality of life and treatment outcome in panic disorder: cognitive behavior group therapy effects in patients refractory to medication treatment. Psychother Psychosom 75:183–186. https://doi.org/10.1159/000091776 CrossRefPubMed

11.

Kersting A, Dölemeyer R, Steinig J, Walter F, Kroker K, Baust K, Wagner B (2013) Brief Internet-based intervention reduces posttraumatic stress and prolonged grief in parents after the loss of a child during pregnancy: a randomized controlled trial. Psychother Psychosom 82:372–381. https://doi.org/10.1159/000348713 CrossRefPubMed

12.

Revicki DA, Kleinman L, Cella D (2014) A history of health-related quality of life outcomes in psychiatry. Dialogues Clin Neurosci 16:127–135 PubMedPubMedCentral

13.

Dunlop BW, Li T, Kornstein SG, Friedman ES, Rothschild AJ, Pedersen R, Ninan P, Keller M (2010) Correlation between patient and clinician assessments of depression severity in the PREVENT study. Psychiatry Res 177:177–183. https://doi.org/10.1016/j.psychres.2010.02.008 CrossRefPubMedPubMedCentral

14.

Schaub D, Brüne M, Bierhoff H‑W, Juckel G (2012) Comparison of self- and clinician’s ratings of personal and social performance in patients with schizophrenia: the role of insight. Psychopathology 45:109–116. https://doi.org/10.1159/000330260 CrossRefPubMed

15.

Gao K, Wu R, Wang Z, Ren M, Kemp DE, Chan PK, Conroy CM, Serrano MB, Ganocy SJ, Calabrese JR (2015) Disagreement between self-reported and clinician-ascertained suicidal ideation and its correlation with depression and anxiety severity in patients with major depressive disorder or bipolar disorder. J Psychiatr Res 60:117–124. https://doi.org/10.1016/j.jpsychires.2014.09.011 CrossRefPubMed

16.

Lindström E, Lewander T, Malm U, Malt UF, Lublin H, Ahlfors UG (2001) Patient-rated versus clinician-rated side effects of drug treatment in schizophrenia: Clinical validation of a self-rating version of the UKU Side Effect Rating Scale (UKU-SERS-Pat). Nord J Psychiatry 55:5–69. https://doi.org/10.1080/080394801317084428 CrossRefPubMed

17.

Zimmerman M, Walsh E, Friedman M, Boerescu DA, Attiullah N (2018) Are self-report scales as effective as clinician rating scales in measuring treatment response in routine clinical practice? J Affect Disord 225:449–452. https://doi.org/10.1016/j.jad.2017.08.024 CrossRefPubMed

18.

Riley WT, Pilkonis P, Cella D (2011) Application of the national institutes of health patient-reported outcome measurement information system (PROMIS) to mental health research. J Ment Health Policy Econ 14:201–208 PubMedPubMedCentral

19.

Uher R, Perlis RH, Placentino A, Dernovšek MZ, Henigsberg N, Mors O, Maier W, McGuffin P, Farmer A (2012) Self-report and clinician-rated measures of depression severity: can one replace the other? Depress Anxiety 29:1043–1049. https://doi.org/10.1002/da.21993 CrossRefPubMedPubMedCentral

20.

Sartorius N (2014) Patient-reported outcomes in psychiatry. Dialogues Clin Neurosci 16:123–124 PubMedPubMedCentral

21.

Beck AT, Steer RA, Brown GK (1996) Manual for the Beck Depression Inventory–II. Psychological Corporation, San Antonio, S 72498–78204

22.

Herrmann-Lingen C, Buss U, Snaith RP (1995) HADS-D – Hospital Anxiety and Depression Scale – Deutsche Version: Ein Fragebogen zur Erfassung von Angst und Depressivität in der somatischen Medizin. Huber, Bern

23.

Derogatis LR, Fitzpatrick M (2004) Test 3:1–41. https://doi.org/10.1037/024099 CrossRef

24.

John OP, Srivastava S (1999) The Big Five trait taxonomy: History, measurement, and theoretical perspectives. Handb Pers Theory Res 2:102–138

25.

Skevington SM, Lotfy M, O’Connell KA, WHOQOL Group (2004) The World Health Organization’s WHOQOL-BREF quality of life assessment: psychometric properties and results of the international field trial. A report from the WHOQOL group. Qual Life Res 13:299–310. https://doi.org/10.1023/B:QURE.0000018486.91360.00 CrossRefPubMed

26.

Shimokawa K, Lambert MJ, Smart DW (2010) Enhancing treatment outcome of patients at risk of treatment failure: Meta-analytic and mega-analytic review of a psychotherapy quality assurance system. J Consult Clin Psychol 78:298–311. https://doi.org/10.1037/a0019247 CrossRefPubMed

27.

Carlier IVE, Meuldijk D, Van Vliet IM, Van Fenema E (2012) N.J. a Van der Wee, F.G. Zitman, Routine outcome monitoring and feedback on physical or mental health status: evidence and theory. J Eval Clin Pract 18:104–110. https://doi.org/10.1111/j.1365-2753.2010.01543.x CrossRefPubMed

28.

Boswell JF, Kraus DR, Miller SD, Lambert MJ (2015) Implementing routine outcome monitoring in clinical practice: Benefits, challenges, and solutions. Psychother Res 25:6–19. https://doi.org/10.1080/10503307.2013.817696 CrossRefPubMed

29.

Rosa C, Campbell ANC, Miele GM, Brunner M, Winstanley EL (2015) Using e‑technologies in clinical trials. Contemp Clin Trials 45:41–54. https://doi.org/10.1016/j.cct.2015.07.007 CrossRefPubMedPubMedCentral

30.

Kesterke N, Egeter J, Erhardt JB, Jost B, Giesinger K (2015) Patient-reported outcome assessment after total joint replacement: comparison of questionnaire completion times on paper and tablet computer. Arch Orthop Trauma Surg 135:935–941. https://doi.org/10.1007/s00402-015-2222-x CrossRefPubMed

31.

De Beurs E, Den Hollander-Gijsman ME, Van Rood YR, Van Der Wee NJA, Giltay EJ, Van Noorden MS, Van Der Lem R, Van Fenema E, Zitman FG (2011) Routine outcome monitoring in the Netherlands: Practical experiences with a web-based strategy for the assessment of treatment outcome in clinical practice. Clin Psychol Psychother 18:1–12. https://doi.org/10.1002/cpp.696 CrossRefPubMed

32.

Aben I, Verhey F, Lousberg R, Lodder J, Honig A (2002) Validity of the beck depression inventory, hospital anxiety and depression scale, SCL-90, and Hamilton depression rating scale as screening instruments for depression in stroke patients. Psychosomatics 43:386–393. https://doi.org/10.1176/appi.psy.43.5.386 CrossRefPubMed

33.

Gilbody SM, House AO, Sheldon T (2002) Routine administration of Health Related Quality of Life (HRQoL) and needs assessment instruments to improve psychological outcome—a systematic review. Psychol Med 32:1345–1356. https://doi.org/10.1017/s0033291702006001 CrossRefPubMed

34.

Kendrick T, El-Gohary M, Stuart B, Gilbody S, Churchill R, Aiken L, Bhattacharya A, Gimson A, Brütt AL, de Jong K, Moore M (2016) Routine use of patient reported outcome measures (PROMs) for improving treatment of common mental health disorders in adults. Cochrane Database Syst Rev. https://doi.org/10.1002/14651858.CD011119.pub2 CrossRefPubMed

35.

Harmon C, Hawkins EJ, Lambert MJ, Slade K, Whipple JS (2005) Improving outcomes for poorly responding clients: the use of clinical support tools and feedback to clients. J Clin Psychol 61:175–185. https://doi.org/10.1002/jclp.20109 CrossRefPubMed

36.

Wing JK, Beevor AS, Curtis RH, Park SGB, Hadden J, Burns A (1998) Health of the nation outcome scales (hoNOS). Br J Psychiatry 172:11–18. https://doi.org/10.1192/bjp.172.1.11 CrossRefPubMed

37.

Roe D, Gelkopf M, Gornemann MI, Baloush-Kleinman V, Shadmi E (2015) Implementing routine outcome measurement in psychiatric rehabilitation services in Israel. Int Rev Psychiatry 27:345–353. https://doi.org/10.3109/09540261.2015.1025722 CrossRefPubMed

38.

Roe D, Drake RE, Slade M (2015) Routine outcome monitoring: an international endeavour. Int Rev Psychiatry 27:257–260. https://doi.org/10.3109/09540261.2015.1070552 CrossRefPubMed

39.

Kilbourne AM, Neumann MS, Pincus HA, Bauer MS, Stall R (2007) Implementing evidence-based interventions in health care: application of the replicating effective programs framework. Implement Sci 2:42. https://doi.org/10.1186/1748-5908-2-42 CrossRefPubMedPubMedCentral

40.

Holzner B, Giesinger JM, Pinggera J, Zugal S, Schöpf F, Oberguggenberger AS, Gamper EM, Zabernigg A, Weber B, Rumpold G (2012) The computer-based health evaluation software (CHES): a software for electronic patient-reported outcome monitoring. BMC Med Inform Decis Mak 12:126. https://doi.org/10.1186/1472-6947-12-126 CrossRefPubMedPubMedCentral

41.

Egeter J, Hüfner K, Sztankay M, Holzner B, Sperner-Unterweger B (2018) Implementation of an electronic routine outcome monitoring at an inpatient unit for psychosomatic medicine. J Psychosom Res 105:64–71. https://doi.org/10.1016/j.jpsychores.2017.12.009 CrossRefPubMed

42.

Royal College of Psychiatrists (2012) What is HoNOS? http://www.rcpsych.ac.uk/traininpsychiatry/eventsandcourses/courses/honos/whatishonos.aspx. Zugegriffen: 15. Mai 2018

43.

Prabhu R, Oakley Browne M (2008) The use of the health of the nation outcome scale in an outreach rehabilitation program, Australas. Psychiatry 16:195–199. https://doi.org/10.1080/10398560701784813 CrossRef

44.

Velikova G, Booth L, Smith AB, Brown PM, Lynch P, Brown JM, Selby PJ (2004) Measuring quality of life in routine oncology practice improves communication and patient well-being: a randomized controlled trial. J Clin Oncol 22:714–724. https://doi.org/10.1200/JCO.2004.06.078 CrossRefPubMed

45.

Stafford L, Berk M, Jackson HJ (2007) Validity of the Hospital Anxiety and Depression Scale and Patient Health Questionnaire-9 to screen for depression in patients with coronary artery disease. Gen Hosp Psychiatry 29:417–424. https://doi.org/10.1016/j.genhosppsych.2007.06.005 CrossRefPubMed

46.

Dozois DJA, Westra HA, Collins KA, Fung TS, Garry JKF (2004) Stages of change in anxiety: psychometric properties of the university of Rhode island change assessment (URICA) scale. Behav Res Ther 42:711–729. https://doi.org/10.1016/S0005-7967(03)00193-1 CrossRefPubMed

47.

Hasler G, Klaghofer R, Buddeberg C (2003) The university of Rhode Island change assessment scale (URICA). Psychother Psychosom Med Psychol 53:406–411. https://doi.org/10.1055/s-2003-42172 CrossRef

48.

Broadbent E, Petrie KJ, Main J, Weinman J (2006) The brief illness perception questionnaire. J Psychosom Res 60:631–637. https://doi.org/10.1016/j.jpsychores.2005.10.020 CrossRefPubMed

49.

Ferreira-Valente MA, Pais-Ribeiro JL, Jensen MP (2011) Validity of four pain intensity rating scales. Pain 152:2399–2404. https://doi.org/10.1016/j.pain.2011.07.005 CrossRefPubMed

Titel: Elektronisches Routine-Outcome-Monitoring (eROM) in Psychiatrie und klinischer Psychologie
eROM-Implementierungsbeispiel an der Universitätsklinik für Psychiatrie II in Innsbruck
Autoren:: Mag. Jonas Egeter
Lisa M. Wintner
Nathalie Huber
Gerhard Rumpold
Barbara Sperner-Unterweger
Harald R. Bliem
Bernhard Holzner
Publikationsdatum: 14.08.2018
DOI: https://doi.org/10.1007/s00739-018-0490-2
Verlag: Springer Vienna
Zeitschrift: psychopraxis. neuropraxis Zeitschrift für praktische Psychiatrie und Neurologie
Ausgabe Sonderheft 1/2018
Print ISSN: 2197-9707
Elektronische ISSN: 2197-9715

Springer Medizin Österreich

Tipp

Weitere Artikel dieser Ausgabe durch Wischen aufrufen

Zusammenfassung

Weitere Artikel der Sonderheft 1/2018

Braucht es eine pädiatrische Psychosomatik?

„Auf Herz und Hirn“ aus psychiatrischer Sicht

Aufgaben einer künftigen Psychiatrie

Vernetzte Versorgung Suchtkranker

Hilfe für Kinder psychisch kranker Eltern

Neue Versorgungslandschaften in der Psychiatrie und Psychosomatik