Improving outpatient treatment in schizophrenia: effects of computerized guideline implementation--results of a multicenter-study within the German research network on schizophrenia.
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Improving outpatient treatment in schizophrenia: effects of computerized guideline implementation--results of a multicenter-study within the German research network on schizophrenia. / Janssen, B; Ludwig, S; Eustermann, H; Menke, R; Härter, Martin; Berger, M; Adam, G; Seemann, U; Kissling, W; Gaebel, W.
In: EUR ARCH PSY CLIN N, Vol. 260, No. 1, 1, 2010, p. 51-57.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
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TY - JOUR
T1 - Improving outpatient treatment in schizophrenia: effects of computerized guideline implementation--results of a multicenter-study within the German research network on schizophrenia.
AU - Janssen, B
AU - Ludwig, S
AU - Eustermann, H
AU - Menke, R
AU - Härter, Martin
AU - Berger, M
AU - Adam, G
AU - Seemann, U
AU - Kissling, W
AU - Gaebel, W
PY - 2010
Y1 - 2010
N2 - Schizophrenia clinical practice guidelines are developed to provide expert- and evidence-based advice to practicing psychiatrists in order to improve the management of this disorder. However, the application of these guidelines in everyday health care can still be described as nonsatisfying. Within the project "Guideline-supported quality management in outpatient treatment", we investigated whether guideline adherence and quality of outcome can be improved by implementing a computer-based, guideline-oriented decision-support system. Therefore, a disease-specific decision-support system was developed interactively presenting guidelines to support the physicians decision-making process during the treatment of schizophrenia patients. We evaluated the system in a control group design: An experimental group consisting of 15 psychiatrists in private practice used the decision-support system, thus documenting the treatment of schizophrenic patients. Guideline-based algorithms were interactively and case specifically displayed on the PC-screen as soon as predefined triggers were met. A first control group in Munich provided treatment-as-usual, documenting the treatment via paper-pencil. Two further physician groups served as additional comparison groups: one also documented electronically using the decision-support system, however without receiving electronic guideline support, the second group carried out traditional quality circles while also using the paper-pencil approach. As a result of the intervention, we observed a strong initial but time-limited improvement with respect to the core aspects of outpatient treatment in schizophrenia in the experimental group. The findings suggest that decision-support systems, despite their limitations, can be used to enhance treatment outcome in schizophrenia outpatient care.
AB - Schizophrenia clinical practice guidelines are developed to provide expert- and evidence-based advice to practicing psychiatrists in order to improve the management of this disorder. However, the application of these guidelines in everyday health care can still be described as nonsatisfying. Within the project "Guideline-supported quality management in outpatient treatment", we investigated whether guideline adherence and quality of outcome can be improved by implementing a computer-based, guideline-oriented decision-support system. Therefore, a disease-specific decision-support system was developed interactively presenting guidelines to support the physicians decision-making process during the treatment of schizophrenia patients. We evaluated the system in a control group design: An experimental group consisting of 15 psychiatrists in private practice used the decision-support system, thus documenting the treatment of schizophrenic patients. Guideline-based algorithms were interactively and case specifically displayed on the PC-screen as soon as predefined triggers were met. A first control group in Munich provided treatment-as-usual, documenting the treatment via paper-pencil. Two further physician groups served as additional comparison groups: one also documented electronically using the decision-support system, however without receiving electronic guideline support, the second group carried out traditional quality circles while also using the paper-pencil approach. As a result of the intervention, we observed a strong initial but time-limited improvement with respect to the core aspects of outpatient treatment in schizophrenia in the experimental group. The findings suggest that decision-support systems, despite their limitations, can be used to enhance treatment outcome in schizophrenia outpatient care.
KW - Adult
KW - Humans
KW - Male
KW - Aged
KW - Female
KW - Middle Aged
KW - Practice Guidelines as Topic
KW - Psychiatric Status Rating Scales
KW - Adolescent
KW - Young Adult
KW - Treatment Outcome
KW - Quality Assurance, Health Care
KW - Germany epidemiology
KW - Ambulatory Care methods
KW - Statistics as Topic
KW - Patient Compliance
KW - Retrospective Studies
KW - Cognitive Therapy methods
KW - Outcome Assessment (Health Care)
KW - Analysis of Variance
KW - Decision Support Systems, Clinical
KW - Decision Making, Computer-Assisted
KW - Schizophrenia epidemiology
KW - Adult
KW - Humans
KW - Male
KW - Aged
KW - Female
KW - Middle Aged
KW - Practice Guidelines as Topic
KW - Psychiatric Status Rating Scales
KW - Adolescent
KW - Young Adult
KW - Treatment Outcome
KW - Quality Assurance, Health Care
KW - Germany epidemiology
KW - Ambulatory Care methods
KW - Statistics as Topic
KW - Patient Compliance
KW - Retrospective Studies
KW - Cognitive Therapy methods
KW - Outcome Assessment (Health Care)
KW - Analysis of Variance
KW - Decision Support Systems, Clinical
KW - Decision Making, Computer-Assisted
KW - Schizophrenia epidemiology
M3 - SCORING: Zeitschriftenaufsatz
VL - 260
SP - 51
EP - 57
JO - EUR ARCH PSY CLIN N
JF - EUR ARCH PSY CLIN N
SN - 0940-1334
IS - 1
M1 - 1
ER -
