Dey Ayan, Lewis Ze'ev, Posel Josh, Pan Rachel Yunqiu, Wang Karen
Psychiatry, University of Toronto, Toronto, Ontario, Canada
Psychiatry, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada.
BMJ Ment Health. 2025 Aug 27;28(1):e301663. doi: 10.1136/bmjment-2025-301663.
Measurement based care (MBC) is a patient-centered approach that is gaining popularity in healthcare systems, particularly in mental health settings. However, attitudes towards MBC vary among mental health clinicians and patients, leading to variable implementation.
This systematic review synthesises clinician and patient perspectives on the benefits and drawbacks of measurement-based care (MBC) in psychiatry.
We searched Ovid MEDLINE, EMBASE, EBM Reviews, APA PsychINFO and CINAHL databases from inception to January 2024. After screening 1644 titles and abstracts, 48 full papers were reviewed, and 24 studies were ultimately included. Quality assessment was conducted using the Mixed Methods Appraisal Tool, and key patterns were extracted using thematic analysis.
The review reflects opinions of 901 patients and 2831 clinicians across various settings. Patients valued MBC for enhancing communication, self-awareness and reducing stigma. However, they expressed concerns about the adequacy of measures in reflecting their clinical state and uncertainty about how responses influence treatment decisions. Clinicians appreciated MBC for improving patient involvement, tracking treatment response and enhancing communication efficiency. Concerns included inadequate capture of clinical complexity, potential reporting biases, time constraints, insufficient training and concerns with respect to data usage and privacy.
While patients and clinicians recognise significant benefits, including enhanced communication, improved insight and more structured clinical decision-making, they also identify important limitations. These include concerns about the adequacy of scales to capture complex clinical presentations, potential impacts on the therapeutic alliance and increased administrative burden. Moving forward, successful integration of MBC into routine care will require addressing these challenges through improved clinician training, clear guidelines for interpretation, greater transparency with respect to how data will be used and more seamless integration with existing clinical workflows.
PROSPERO CRD420250651562.
基于测量的护理（MBC）是一种以患者为中心的方法，在医疗系统中越来越受欢迎，尤其是在心理健康领域。然而，心理健康临床医生和患者对MBC的态度各不相同，导致实施情况参差不齐。
本系统评价综合了临床医生和患者对精神病学中基于测量的护理（MBC）的益处和弊端的观点。
我们检索了从数据库建立至2024年1月的Ovid MEDLINE、EMBASE、循证医学评论、美国心理学会心理学文摘数据库和护理学与健康领域数据库。在筛选了1644篇标题和摘要后，对48篇全文进行了评审，最终纳入24项研究。使用混合方法评估工具进行质量评估，并采用主题分析提取关键模式。
该评价反映了来自不同环境的901名患者和2831名临床医生的意见。患者重视MBC在加强沟通、自我认知和减少耻辱感方面的作用。然而，他们对测量方法能否充分反映其临床状态表示担忧，并且对其反应如何影响治疗决策感到不确定。临床医生赞赏MBC在提高患者参与度、跟踪治疗反应和提高沟通效率方面的作用。担忧包括未能充分捕捉临床复杂性、潜在的报告偏倚、时间限制、培训不足以及对数据使用和隐私的担忧。
虽然患者和临床医生认识到包括加强沟通、提高洞察力和更有条理的临床决策等显著益处，但他们也指出了重要的局限性。这些包括对量表能否充分捕捉复杂临床表现的担忧、对治疗联盟的潜在影响以及行政负担加重。展望未来，要将MBC成功整合到常规护理中，需要通过改进临床医生培训、明确的解释指南、提高数据使用的透明度以及与现有临床工作流程更无缝的整合来应对这些挑战。
PROSPERO CRD420250651562。
