| Popis: |
Over the last decade, more than 20 early intervention (EI) programs have been initiated throughout the Netherlands. Routine Outcome Monitoring (ROM) measures have been proposed, to follow-up the course of psychotic disorders in individual patients, to improve the quality of care and to evaluate treatment programs. Key components of ROM are symptomatic and functional remission, and metabolic complications of use of antipsychotic medication. The implementation and preliminary results of ROM in EI programs in the Netherlands will be discussed. One of the examples is Parnassia Centre for Early Psychosis in The Hague. From 2007 onwards, clinicians administer the Panss routinely twice per year in all patients. In May, 2010, 255 patients (81% of referrals) had had at least one Panss assessment. The proportion of patients in symptomatic remission gradually increased with each assessment, from 49% after 6 months to 67% at the fourth assessment. The majority of patients, however, did not complete all assessments, because they dropped out of treatment or did not show up for the Panss interviews. Of the patients referred in 2008, only 35% had an assessment after 1 year. This example suggests that ROM is feasible in EI, but also that implementation is difficult. By definition, ROM is vulnerable for missing data. Considerable (and not random) loss of follow-up implies that results may not be representative for the total patient populations. Thus, while ROM is valuable for evaluating the course of illness in individual patients, ROM may be less appropriate for evaluation of treatment programs. |
