Do Schizophrenia Patients Receive the Care They Need? From Routine Outcome Monitoring to Evidence Based Treatment

Abstract

Introduction In schizophrenia the life expectancy is significantly lower compared to the general population. To monitor their functioning over the course of the illness, a protocol for routine outcome monitoring (ROM) has been developed in the Netherlands. Objective This study investigated the effectiveness of Routine Outcome Monitoring (ROM) in clinical practice. More specifically, we investigated whether ROM outcomes resulted in treatment in accordance with guidelines for schizophrenia. Methods Out of the ROM database of 2010 (n=1040), a random sample of 100 patients diagnosed with a psychotic disorder was taken. Data from blood tests, a physical examination, interviews, and standardized questionnaires were used. The prevalence of cardiovascular risk factors, psychosocial problems and sexual dysfunctions was calculated. Offered treatment was investigated with the treatment plans of patients. Results The sample consisted of 63 males and 37 females. The average age was 44 and the average duration of illness was 17.7 years. High prevalences of cardiovascular risk factors, psychosocial problems and sexual dysfunctions were found. Cardiovascular risk factors remained untreated in 61% of cases, psychosocial problems remained untreated in 85% of cases and sexual dysfunctions were not treated at all in our sample. Conclusions High rates of non-treatment were found for cardiovascular risk factors, psychosocial problems and sexual dysfunctions, despite high prevalences as identified with ROM. Thus, ROM outcomes do not result in treatment in accordance with guidelines for the majority of patients. Steps are necessary to bridge the gap between ROM and treatment to ensure this group of severely mentally ill patients receives the best possible treatment.