Zhang Haonan, Sun Ping, Wang Xing, Yang Xiaorui, He Yuru, Yang Tao, Su Yousong, Fu Yi, Li Qingwei, Sun Jinhua, Liu Jing, Murphy Jill K, Michalak Erin E, Lam Raymond W, Chen Jun, Fang Yiru
Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, People's Republic of China.
Qingdao Mental Health Center, Qingdao, Shandong, People's Republic of China.
Neuropsychiatr Dis Treat. 2024 Dec 11;20:2405-2421. doi: 10.2147/NDT.S476484. eCollection 2024.
Measurement-based care (MBC) is an emerging, objective, and systematic evidence-based practice for monitoring symptom severity and treatment efficacy to assist clinicians in developing individualized treatment strategies for patients with major depressive disorder (MDD). This study aimed to identify the barriers and facilitators of enhanced MBC (eMBC) in the outpatient setting to clarify the eMBC utilization dilemma.
Between September 2022 and June 2023, we collected the opinions of healthcare providers, adult and adolescent patients, and family members of adolescent patients via online surveys. Specifically, we surveyed their acceptance and perspectives on MBC and eMBC primarily through custom-designed Likert scales developed for this study.
We received responses from 270 adult patients, 144 adolescent patients, 109 family members, and 355 healthcare providers. The results showed that 85.3% of patients and family members were willing to use the eMBC intervention. However, adolescent patients responded significantly differently from the other two groups, with lower acceptance and confidence. Among healthcare providers, while only 69.9% used MBC in practice, 94% believed standardized scales would be effective in treatment, and 91.8% were willing to try eMBC. Additionally, we received 277 remarks regarding eMBC from patients and families.
In general, both clinicians and patients looked forward to using eMBC and recognized the potential benefits. However, they still had many concerns about privacy, professionalism, and time consumption. Responses from adolescent patients appeared more conservative and lacked confidence in eMBC. Further implementations are required to explore how eMBC can be operationalized in the outpatient setting to help different patients.
基于测量的护理（MBC）是一种新兴的、客观的、系统的循证实践，用于监测症状严重程度和治疗效果，以协助临床医生为重度抑郁症（MDD）患者制定个性化治疗策略。本研究旨在确定门诊环境中强化MBC（eMBC）的障碍和促进因素，以阐明eMBC的应用困境。
在2022年9月至2023年6月期间，我们通过在线调查收集了医疗服务提供者、成年和青少年患者以及青少年患者家属的意见。具体而言，我们主要通过为本研究设计的定制李克特量表，调查了他们对MBC和eMBC的接受程度和看法。
我们收到了270名成年患者、144名青少年患者、109名家属和355名医疗服务提供者的回复。结果显示，85.3%的患者和家属愿意使用eMBC干预措施。然而，青少年患者的反应与其他两组有显著差异，接受度和信心较低。在医疗服务提供者中，虽然只有69.9%的人在实践中使用MBC，但94%的人认为标准化量表在治疗中会有效，91.8%的人愿意尝试eMBC。此外，我们收到了患者和家属关于eMBC的277条意见。
总体而言，临床医生和患者都期待使用eMBC，并认识到其潜在益处。然而，他们对隐私、专业性和时间消耗仍有诸多担忧。青少年患者的反应显得更为保守，对eMBC缺乏信心。需要进一步开展实施工作，以探索如何在门诊环境中实施eMBC，以帮助不同的患者。
