Abstract
AimsThe DIALOG scale has been implemented as a routine patient outcome and experience measure (PROM/PREM) in a mental health trust in East London since 2017. The resulting healthcare dataset was used to estimate satisfaction with life and treatment aspects over time and factors associated with it.MethodsVariables available from the Trust were DIALOG items, service level, clinical and basic demographic data. Data was extracted in February 2019. Data is described using a range of descriptive statistics and looking at the subgroups: treatment stage, diagnosis, service type. Predictors for average DIALOG scores across patients was explored with clustered linear regression models. A fixed effect model was chosen to estimate the impact of clinical and service related variables on patient’s average DIALOG scores over time. Sensitivity analyses with the whole data set and complete cases were carried out.ResultsOf the original 18,481 DIALOG records 12, 592 were kept after data cleaning (5646 patients). The average DIALOG score was 4.8 (SD 1.0) on the 7-point scale. Average satisfaction with life aspects (PROM) was 4.65 (SD 1.1) and with treatment aspects (PREM) was 5.25 (SD 1.17). Across all 11 items, “job situation” scored lowest (mean 4.05) and “meetings with professionals” highest (mean 5.5). Satisfaction for all items increased over time (average increase 0.47). The largest increase was in “mental health” (0.94) and the smallest in “family relationships” (0.34).ConclusionsPatients in mental healthcare services were “fairly satisfied” in both life and treatment aspects with improvements seen over time. These results will act as a benchmark for clinical services currently implementing DIALOG across the UK and inform local service developments.
Highlights
Patient-reported outcome and experience measures (PROM/Patient Experience Measure (PREM)) have been developed to include the patient perspective in healthcare delivery and quality improvement [1]
Demographic, clinical, and service -level characteristics There were a total of 18,481 DIALOG records from 7763 patients recorded within the time span of 3 years
The average Health of the Nation Outcome Scales (HoNOS) score was 14.1 and 18% of records came from patients with a legal status, i.e. those in services under the Mental Health Act
Summary
Patient-reported outcome and experience measures (PROM/PREM) have been developed to include the patient perspective in healthcare delivery and quality improvement [1]. In mental healthcare subjective quality of life (SQOL) is a useful PROM as improving quality of People with diagnoses of mental health disorders are reported to have lower quality of life than the general population [6]. Cross-sectional studies have struggled to identify consistent associations between subjective quality of life and social and clinical variables. Symptoms of anxiety and depression as well as “number of unmet needs” are reported most consistently. Mosler et al BMC Health Services Research (2020) 20:1020 to have large negative impact on SQOL [3, 7]. Studies tracking SQOL over time have been inconsistent on whether improvements occur [9]
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