Improvement in IAPT outcomes over time: are they driven by changes in clinical practice?
IAPT
assessment
diagnosis
psychological therapy
treatment outcome
Journal
Cognitive behaviour therapist
ISSN: 1754-470X
Titre abrégé: Cogn Behav Therap
Pays: England
ID NLM: 101565750
Informations de publication
Date de publication:
2020
2020
Historique:
received:
21
10
2019
revised:
04
02
2020
accepted:
17
04
2020
entrez:
22
2
2021
pubmed:
23
2
2021
medline:
23
2
2021
Statut:
epublish
Résumé
Treatment outcomes across Improving Access to Psychological Therapies (IAPT) services in England have improved year-on-year, with the national average proportion of patients in recovery at the end of treatment now exceeding the 50% target. This is despite the number of referrals and numbers of treated patients also increasing year-on-year, suggesting that services have evolved local practices and treatment delivery to meet needs whilst improving performance. This study explores whether there have been changes in clinical practice with regard to: (1) the number of sessions and length of treatments; (2) the number of cancellations and non-attendance; and (3) the recording of problem descriptor information, and the association with treatment outcomes in IAPT. Routinely collected data from seven IAPT services involved in the North and Central East London (NCEL) IAPT Service Improvement and Research Network (SIRN) were brought together to form a dataset of nearly 88,000 patients who completed a course of IAPT treatment. Results showed that there was a slight increase in the average number of sessions, and decreases in the length of time in treatment, as well as decreases in both the number of non-attended appointments and the use of inappropriate problem descriptors. These findings highlight a number of areas where potentially small changes to clinical practice may have had positive effects on patient outcomes. The value of using IAPT data to inform service improvement evaluations is discussed. (1)How changes to treatment-delivery factors are associated with IAPT patient outcomes.(2)The link between clinical practice and potential service performance.(3)How analysing routinely collected data can be used to inform service improvement.
Identifiants
pubmed: 33613689
doi: 10.1017/S1754470X20000173
pii: S1754470X20000173
pmc: PMC7872157
doi:
Types de publication
Journal Article
Langues
eng
Pagination
e16Informations de copyright
© British Association for Behavioural and Cognitive Psychotherapies 2020.
Références
BMJ Open. 2015 May 20;5(5):e006103
pubmed: 25995234
Lancet. 2018 Feb 17;391(10121):679-686
pubmed: 29224931
J Affect Disord. 2013 Jul;149(1-3):1-13
pubmed: 23528438
Behav Res Ther. 2013 Sep;51(9):597-606
pubmed: 23872702
Annu Rev Clin Psychol. 2018 May 7;14:159-183
pubmed: 29350997
Br J Psychiatry. 2000 Apr;176:379-86
pubmed: 10827888
Arch Intern Med. 2006 May 22;166(10):1092-7
pubmed: 16717171
Behav Res Ther. 1997 Aug;35(8):741-56
pubmed: 9256517
J Affect Disord. 2019 Apr 15;249:327-335
pubmed: 30802698
Behav Res Ther. 2020 Jan;124:103505
pubmed: 31841709
Behav Cogn Psychother. 2013 May;41(3):365-70
pubmed: 23211066
Int Rev Psychiatry. 2011 Aug;23(4):318-27
pubmed: 22026487
J Affect Disord. 2016 Jun;197:107-15
pubmed: 26991365
BMC Psychiatry. 2018 Aug 16;18(1):260
pubmed: 30115041
Clin Psychol Rev. 2018 Aug;64:13-38
pubmed: 30075313
J Consult Clin Psychol. 2015 Dec;83(6):1097-107
pubmed: 26436645
Australas Psychiatry. 2016 Oct;24(5):489-92
pubmed: 27034440
Behav Cogn Psychother. 2019 May;47(3):318-331
pubmed: 30352633
J Gen Intern Med. 2001 Sep;16(9):606-13
pubmed: 11556941
Behav Res Ther. 2017 Jul;94:1-8
pubmed: 28437680
Br J Psychiatry. 2013 Jan;202(1):42-9
pubmed: 23174514