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Bridging the science-to-service gap in schizophrenia care in the Netherlands:the Schizophrenia Quality Improvement Collaborative

By Danielle Van Duin, Gerdien Franx, Bob Van Wijngaarden, Mark Van der Gaag, Jaap Van Weeghel, Cees Slooff and Michel Wensing


<p>Objective. Many patients with schizophrenia are not treated in line with evidence-based guidelines. This study examines the large-scale implementation of the National Multidisciplinary Guideline for schizophrenia in the Netherlands.</p><p>Design. Observational, prospective study, with repeated measurement.</p><p>Setting. Thirty mental healthcare teams in different regions of the Netherlands.</p><p>Participants. Three hundred and fifty-nine clinicians with different professional backgrounds and 1489 patients suffering from schizophrenia.</p><p>Intervention(s). Six evidence-based interventions for schizophrenia were implemented, in the context of a quality improvement collaborative: assertive community treatment (ACT) or its adapted version functional assertive community treatment (FACT), cognitive behavioural therapy, psycho-education, family interventions, individual placement support and pharmacotherapy.</p><p>Main Outcome Measure(s). Professional performance, social functioning and relapse rates.</p><p>Results. Improved professional performance, in line with guidelines. Availability of (F) ACT improved from 23 to 60%. Individual Placement Support improved from 20 to 53%. Complete care plans were composed for 38% of the patients and routine outcome monitoring was introduced in most teams. Social functioning improved slightly (HoNOS mean: from 6.2 to 5.6). Relapse rates did not improve during the course of the study.</p><p>Conclusions. An intensive implementation programme can result in an improved delivery of evidence-based care, increased continuity of care and slightly improved outcomes for individuals with schizophrenia. More rigorous research designs have to confirm these findings.</p>

Topics: quality improvement, quality management; mental health disorders; disease categories; quality indicators; measurement of quality; LONGITUDINAL DATA-ANALYSIS; PRACTICES PROJECT; OUTCOMES; REMISSION; FIDELITY; RELAPSE; IMPACT
Year: 2013
DOI identifier: 10.1093/intqhc
OAI identifier: oai:pure.rug.nl:publications/eafeae9c-7b24-4e07-b05c-53cc84137560
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