BACKGROUND
Outcomes are measured to establish what works, in the context of evaluative research, and
to improve the quality of care that is offered. Traditional outcomes focus upon biomedical
endpoints, but there is an increased interest in patient based outcomes, which measure the
impact of illness or healthcare interventions on the individual and how they live their day-today
life. There are reasons to expect that the application of patient based outcomes would
be especially relevant to the discipline of psychiatry.
AIMS
To explore the measurement of outcome in psychiatric research and practice, with particular
reference to patient based outcomes.
METHODS
1. A critical literature review of the outcomes movement in health care.
2. A survey and systematic review of the methods used to measure outcome in
evaluative psychiatric research (randomised trials and outcomes research).
3. A survey of the use of outcomes measures by UK psychiatrists in their day-to-day
practice.
4. A systematic review of the effectiveness of routine outcomes measurement in
improving the quality of care for those with common psychiatric disorders.
RESULTS
An outcomes movement has emerged in healthcare, which can be understood in social,
political and economic terms. Outcomes measurement in psychiatric research is dominated
by the measurement of psychiatric symptoms, with little reference to patient based
measures. Practising UK psychiatrists rarely measure outcomes. There are substantial
practical and attitudinal barriers to the use of outcomes instruments in NHS mental health
services. There is little evidence to support the potential for routine outcomes measures to
improve the quality of mental healthcare.
DISCUSSION
Current mental health policy places great emphasis on the measurement of outcomes, and
is likely to fail. The potential for patient based outcomes to be adopted in psychiatric
research and practice has yet to be realised. The need for important research into the
suitability and value of patient based outcomes measures in mental health research and
practice is identified
