Aboraya Ahmed, Nasrallah Henry A, Elswick Daniel E, Ahmed Elshazly, Estephan Nevine, Aboraya Dalia, Berzingi Seher, Chumbers Josleen, Berzingi Sara, Justice John, Zafar Jawad, Dohar Sheena
Dr. Aboraya is Chief of Psychiatry at William R. Sharpe, Jr. Hospital, Clinical Professor of Psychiatry at West Virginia School of Osteopathic Medicine, and Adjunct Faculty with the School of Public Health West Virginia University, in Weston, West Virginia.
Dr. Nasrallah is the Sydney Souers Professor and Chairman of the Department of Psychiatry and Behavioral Neuroscience at Saint Louis University School of Medicine in St. Louis, Missouri.
Innov Clin Neurosci. 2018 Nov 1;15(11-12):13-26.
The authors define measurement-based care (MBC) in psychiatry as the use of validated clinical measurement instruments to objectify the assessment, treatment, and clinical outcomes, including efficacy, safety, tolerability, functioning, and quality of life, in patients with psychiatric disorders. MBC includes two processes: routine assessments, such as measuring the severity of symptoms with rating scales, and the use of assessments in decision-making. MBC implementation was tested in the Texas Medication Algorithm Project and the German Algorithm Project and has been shown to improve patient outcomes. Even though more recent research has shown the many benefits of MBC compared to the usual care, MBC is still not the standard of care in psychiatric practice. This review article addresses the advantages of MBC, the barriers to implementing MBC in clinical practice, and the basic properties of MBC instruments. Recent developments in the 21st century that are expected to accelerate the adoption of MBC in clinical practice, including electronic health records, health information technology, and the development of the Standard for Clinicians' lnterview in Psychiatry (SCIP) as an MBC tool, will be reviewed. The authors recommend including MBC in psychiatry residency training to promote its use in future generations.
作者们将精神病学中的基于测量的护理（MBC）定义为使用经过验证的临床测量工具，以客观化对精神疾病患者的评估、治疗及临床结果，包括疗效、安全性、耐受性、功能及生活质量。MBC包括两个过程：常规评估，如使用评定量表测量症状严重程度，以及在决策中使用评估。MBC的实施在德克萨斯药物算法项目和德国算法项目中进行了测试，并已证明能改善患者预后。尽管最近的研究表明，与常规护理相比，MBC有诸多益处，但在精神病学实践中，MBC仍未成为护理标准。这篇综述文章探讨了MBC的优势、在临床实践中实施MBC的障碍以及MBC工具的基本特性。还将回顾21世纪有望加速MBC在临床实践中应用的最新进展，包括电子健康记录、健康信息技术，以及作为MBC工具的《精神病学临床医生访谈标准》（SCIP）的制定。作者们建议在精神病学住院医师培训中纳入MBC，以促进其在后代中的使用。
