Evidence has shown that less than 50% of persons with schizophrenia are receiving care consistent with the scientific evidence. There are potentially many factors contributing to this low level of performance, associated with the interaction of patients, providers, and the mental health system. Previous efforts to improve quality have focused on the physician and to a lesser extent the system. The goal of this research is to empower and activate the patient to understand key elements of what constitutes high quality care for schizophrenia and to discuss with his or her clinician differences between current treatment and evidence-based quality of care standards, based on the Schizophrenia PORT study. Building on the web-based CompareYourCare framework developed and tested by the Foundation for Accountability (FACCT), we will develop, test and evaluate an interactive schizophrenia web-based system that allows the consumer or family member to compare current treatment to evidence-based standards. The research has three aims: (1) Build interactive quality of care educational modules for schizophrenia, adapting the CompareYourCare TM (FACCT) framework and the work of the Mental Health Outcomes Roundtable, and test these modules for acceptability and understandability; (2) Assess the relevance and educational value of these modules for consumers and families in the community versus in the clinic based on patient and family reports; and (3) Examine the impact of these modules on consumers and families, their providers, and the quality of care received, testing clinic and community-based implementation strategies. The web-based educational system will be tested in a clinic environment, with patients completing it prior to a scheduled visit with their therapist, and in a community environment. The expectation is that increasing the knowledge of consumers and families regarding quality of care standards will increase the likelihood of discussion of quality with a therapist and the congruence between treatment and evidence-based quality standards. Also, education is expected to increase self-reported adherence to evidence-based treatments. These hypothesized changes would be expected to improve patient outcomes, including symptom control, functional status, and quality of life.
| Steinwachs, Donald M; Roter, Debra L; Skinner, Elizabeth A et al. (2011) A web-based program to empower patients who have schizophrenia to discuss quality of care with mental health providers. Psychiatr Serv 62:1296-302 |
