The effects of a computerized clinical decision aid on clinical decision-making in psychosis care

Lukas Roebroek*, Jojanneke Bruins, Albert Boonstra, Wim Veling, Frederike Jörg, B. Esther Sportel, Philippe Delespaul, Stynke Castelein

*Corresponding author for this work

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Abstract

Objective
Clinicians in mental healthcare have few objective tools to identify and analyze their patient's care needs. Clinical decision aids are tools that support this process. This study examines whether 1) clinicians working with a clinical decision aid (TREAT) discuss more of their patient's care needs compared to usual treatment, and 2) agree on more evidence-based treatment decisions.

Methods
Clinicians participated in consultations (n = 166) with patients diagnosed with psychotic disorders from four Dutch mental healthcare institutions (research registration number 201700763). Primary outcomes were measured with the modified Clinical Decision-making in Routine Care questionnaire and combined with psychiatric, physical and social wellbeing related care needs. A multilevel analysis compared discussed care needs and evidence-based treatment decisions between treatment as usual (TAU) before, TAU after and the TREAT condition.

Results
First, a significant increase in discussed care needs for TREAT compared to both TAU conditions (β = 20.2, SE = 5.2, p = 0.00 and β = 15.8, SE = 5.4, p = 0.01) was found. Next, a significant increase in evidence-based treatments decisions for care needs was observed for TREAT compared to both TAU conditions (β = 16.7, SE = 4.8, p = 0.00 and β = 16.0, SE = 5.1, p = 0.01).

Conclusion
TREAT improved the discussion about physical health issues and social wellbeing related topics. It also increased evidence-based treatment decisions for care needs which are sometimes overlooked and difficult to treat. Our findings suggest that TREAT makes sense of routine outcome monitoring data and improves guideline-informed care.
Original languageEnglish
Pages (from-to)532-537
Number of pages6
JournalJournal of Psychiatric Research
Volume156
DOIs
Publication statusPublished - Dec-2022

Keywords

  • psychotic disorders
  • decision support
  • guidelines
  • psychiatry

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