Patient preference in psychological treatment and associations with self-reported outcome: national cross-sectional survey in England and Wales

BMC Psychiatry

Research Article

Jeremy Clarke¹  Ryan Williams²  Mike J. Crawford³  Lucy Palmer⁴  Lorna Farquharson⁵  Paul Bassett⁶  David M. Clark⁷ 

[1] College Centre for Quality Improvement, Royal College of Psychiatrists, 21 Prescot Street, E1 8BB, London, UK;Imperial College London, London, UK;Imperial College London, London, UK;College Centre for Quality Improvement, Royal College of Psychiatrists, 21 Prescot Street, E1 8BB, London, UK;Royal Holloway, University of London, London, UK;Royal Holloway, University of London, London, UK;College Centre for Quality Improvement, Royal College of Psychiatrists, 21 Prescot Street, E1 8BB, London, UK;Stats Consultancy, Amersham, UK;University of Oxford, Oxford, UK;

关键词: Psychological treatment;    Choice behaviour;    Patient preference;    Psychotherapy;    Treatment outcome;   

DOI  :  10.1186/s12888-015-0702-8

 received in 2015-06-30, accepted in 2015-12-14,  发布年份 2016

来源: Springer

【 摘 要 】

BackgroundProviders of psychological therapies are encouraged to offer patients choice about their treatment, but there is very little information about what preferences people have or the impact that meeting these has on treatment outcomes.MethodCross-sectional survey of people receiving psychological treatment from 184 NHS services in England and Wales. 14,587 respondents were asked about treatment preferences and the extent to which these were met by their service. They were also asked to rate the extent to which therapy helped them cope with their difficulties.ResultsMost patients (12,549–86.0 %, 95 % CI: 85.5–86.6) expressed a preference for at least one aspect of their treatment. Of these, 4,600 (36.7 %, 95 % CI: 35.8–37.5) had at least one preference that was not met. While most patients reported that their preference for appointment times, venue and type of treatment were met, only 1,769 (40.5 %) of the 4,253 that had a preference for gender had it met. People who expressed a preference that was not met reported poorer outcomes than those with a preference that was met (Odds Ratios: appointment times = 0.29, venue = 0.32, treatment type = 0.16, therapist gender = 0.32, language in which treatment was delivered = 0.40).ConclusionsMost patients who took part in this survey had preferences about their treatment. People who reported preferences that were not met were less likely to state that treatment had helped them with their problems. Routinely assessing and meeting patient preferences may improve the outcomes of psychological treatment.

【 授权许可】

CC BY   
© Williams et al. 2016