Perspectives on Enhanced Measurement-Based Care Among Healthcare Providers, Adults, Adolescent Patients with Major Depressive Disorder and Pediatric Family Members: A Multicenter Online Investigation

Neuropsychiatr Dis Treat. 2024 Dec 11:20:2405-2421. doi: 10.2147/NDT.S476484. eCollection 2024.

Abstract

Objective: 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.

Methods: 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.

Results: 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.

Conclusion: 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.

Keywords: digital health; enhanced measurement-based care; implementation; major depressive disorder; measurement-based care; treatment.

Grants and funding

The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: Jun Chen received support for this study from the National Natural Science Foundation of China (81761128032, 81930033, 81771465), the Clinical Research Plan of SHDC (SHDC12020126), Key Area Research and Development Program of Guangdong Province (2018B030334001), Clinical Research Center of Shanghai Mental Health Center Key Project (CRC2021ZD01, CRC2021DX01), Shanghai Key Clinical Specialties Construction Project (Psychiatry and Mental Health), Shanghai Clinical Research Center for Mental Health (19MC1911100).