Effectiveness of the implementation of guidelines for anxiety disorders in specialized mental health care.

Autor: van Dijk MK; HSK Group, Arnhem and Department of Psychiatry, VU University Medical Centre and GGZinGeest, Amsterdam, the Netherlands., Oosterbaan DB; Department of Psychiatry, UMC St. Radboud and Pro Persona Overwaal, Nijmegen, the Netherlands., Verbraak MJ; Behavioural Science Institute, Radboud University Nijmegen and HSK Group, Arnhem, the Netherlands., Hoogendoorn AW; Department of Psychiatry and EMGO+ Institute for Health and Care Research, VU University Medical Centre and GGZinGeest, Amsterdam, the Netherlands., Penninx BW; Department of Psychiatry and EMGO+ Institute for Health and Care Research, VU University Medical Centre and GGZinGeest, Amsterdam, the Netherlands., van Balkom AJ; Department of Psychiatry and EMGO+ Institute for Health and Care Research, VU University Medical Centre and GGZinGeest, Amsterdam, the Netherlands.
Jazyk: angličtina
Zdroj: Acta psychiatrica Scandinavica [Acta Psychiatr Scand] 2015 Jul; Vol. 132 (1), pp. 69-80. Date of Electronic Publication: 2014 Sep 22.
DOI: 10.1111/acps.12338
Abstrakt: Objective: To examine the effect of implementing anxiety disorders guidelines on guideline adherence and patient outcomes in specialized mental health care.
Method: A treatment setting in which guidelines were implemented (intervention condition) was compared with one in which guidelines were only disseminated (control condition).
Results: Of 61.7% of 81 intervention-condition patients received treatment according to the guidelines vs. 40.6% of 69 control-condition patients (P = 0.01). At 1-year follow-up, intervention-condition patients showed a greater decrease in anxiety symptoms (d = 0.48, P < 0.05); higher percentages of response (52.6% vs. 33.8%; P = 0.025) and remission (33.3% vs.16.9%; P = 0.026); and a greater decrease in the rate of phobic avoidance (d = 0.34, P < 0.05). At 2-year follow-up, control-condition patients had experienced a longer period of treatment, which had eroded most of these differences, except for phobic avoidance.
Conclusion: Systematic guideline implementation results in earlier gains and shorter treatment times.
(© 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)
Databáze: MEDLINE
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