Dean Nathan J, Arnaoutoglou Nikitas, Underwood Benjamin R
Clinical School of Medicine, Cambridge University, UK.
Windsor Research Unit, Fulbourn Hospital, UK.
BJPsych Open. 2020 Mar 20;6(2):e30. doi: 10.1192/bjo.2020.14.
The Health of the Nation Outcomes Scales (HoNOS) has been widely used as an outcome measure in UK mental health settings for the past decade. The data-set gathered provides a unique opportunity to evaluate the effectiveness of the totality of mental healthcare in 'real-world' conditions; much of our clinical evidence currently comes from highly parameterised clinical trials investigating single interventions in highly selected patients.
To examine all outcomes measured by HoNOS for a range of diagnostic groups, evaluate the influence of patient demographics on those outcomes, and observe changes in patient groups over time.
Here we show the data from 6813 adult patients treated in Cambridgeshire between 2012 and 2017. Patients were split into three diagnostic groups: psychosis, non-psychosis and organic. Changes in HoNOS scores from initial assessment to discharge were tested and regressions were used to evaluate the influence of age, gender and ethnicity on the changes, as well as to model changes in the severity of initial presenting symptoms with time.
HoNOS scores significantly improve after treatment for psychotic, non-psychotic and organic conditions in adults and older adults. Age, but not gender or ethnicity, influenced change in HoNOS scores. Patients entering secondary mental health services had increased initial HoNOS scores over time.
The UK repository of HoNOS scores provides a significant and relatively underutilised resource that can be exploited to gain insights into mental illness and treatment effectiveness. This is likely to have many applications, including influencing the commissioning of services.
在过去十年中，《国民健康结果量表》（HoNOS）在英国心理健康环境中被广泛用作结果衡量指标。所收集的数据集提供了一个独特的机会，可在“现实世界”条件下评估整个心理保健的有效性；目前我们的许多临床证据来自对高度选择的患者进行单一干预的高度参数化临床试验。
检查HoNOS针对一系列诊断组所测量的所有结果，评估患者人口统计学特征对这些结果的影响，并观察患者群体随时间的变化。
在此，我们展示了2012年至2017年间在剑桥郡接受治疗的6813名成年患者的数据。患者被分为三个诊断组：精神病、非精神病和器质性疾病。测试了从初始评估到出院时HoNOS评分的变化，并使用回归分析来评估年龄、性别和种族对这些变化的影响，以及模拟初始呈现症状的严重程度随时间的变化。
成人和老年人在患有精神病、非精神病和器质性疾病接受治疗后，HoNOS评分显著改善。年龄而非性别或种族影响了HoNOS评分的变化。进入二级心理健康服务的患者随着时间的推移初始HoNOS评分有所增加。
英国HoNOS评分库提供了一个重要且相对未充分利用的资源，可用于深入了解精神疾病和治疗效果。这可能有许多应用，包括影响服务的委托安排。
