Basic quality indicators for clinical care of patients with major depression, schizophrenia, and bipolar disorder

Eduard Vieta; José Manuel Menchón Magriña; Miguel Bernardo Arroyo; Víctor Pérez Sola; Carmen Moreno Ruiz; Celso Arango López; Julio Bobes García; Manuel Martín Carrasco; Diego Palao Vidal; Ana González-Pinto Arrillaga

doi:10.1016/j.rpsm.2023.03.001

Basic quality indicators for clinical care of patients with major depression, schizophrenia, and bipolar disorder

Span J Psychiatry Ment Health. 2024 Apr-Jun;17(2):103-109. doi: 10.1016/j.rpsm.2023.03.001. Epub 2023 May 29.

Affiliations

¹ Hospital Clínic, Bipolar and Depressive Disorders Unit, Neurosciences Institute, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Spain.
² Hospital Universitario de Bellvitge-IDIBELL, University of Barcelona, CIBERSAM, Barcelona, Spain.
³ Hospital Clínic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Spain.
⁴ Neuropsychiatry and Addcitions Institute, Hospital del Mar, CIBERSAM, ISCIII, IMIM (Hospital del Mar Institute of Medicine Research), Psychiatry Department, Autonomous University of Barcelona, Barcelona, Spain.
⁵ Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, IiSGM, CIBERSAM, School of Medicine, Complutense University of Madrid, Madrid, Spain.
⁶ Hospital Universitario Central de Asturias (HUCA), ISPA, INEUROPA, CIBERSAM, ISCIII, University of Oviedo, Oviedo, Spain.
⁷ Padre Menni Psychiatric Clinic (Hospitaller Sisters), Pamplona, Spain.
⁸ Hospital Universitario Parc Taulí-Mental Health, I3PT-INc Translational Neuroscience Unit, Autonomous University of Barcelona, CIBERSAM, ISCIII, Sabadell, Barcelona, Spain.
⁹ Department of Psychiatry, BIOARABA, Hospital Universitario de Álava-Santiago, CIBERSAM, ISCIII, University of the Basque Country, Vitoria-Gasteiz, Spain. Electronic address: anapinto@telefonica.net.

PMID: 37852877
DOI: 10.1016/j.rpsm.2023.03.001

Abstract

Objective: To identify a set of indicators to monitor the quality of care for patients with major depression, schizophrenia, or bipolar disorder.

Methods: A group of 10 experts selected the most automatically applicable indicators from a total of 98 identified in a previous study. Five online sessions and 5 discussion meetings were performed to select the indicators that met theoretical feasibility criteria automatically. Subsequently, feasibility was tested in a pilot study conducted in two hospitals of the Spanish Health Service.

Results: After evaluating its measurement possibilities in the Spanish Health Service, and the fulfillment of all the quality premises defined, 16 indicators were selected. Three were indicators of major depression, 5 of schizophrenia, 3 of bipolar disorder, and 5 indicators common to all three pathologies. They included measures related to patient safety, maintenance and follow-up of treatment, therapeutic adherence, and adequacy of hospital admissions. After the pilot study, 5 indicators demonstrated potential in the automatic generation of results, with 3 of them related to treatments (clozapine in schizophrenia, lithium for bipolar disorder, and valproate in women of childbearing age).

Conclusions: Indicators support the monitoring of the quality of treatment of patients with major depression, schizophrenia, or bipolar disorder. Based on this proposal, each care setting can draw up a balanced scorecard adjusted to its priorities and care objectives, which will allow for comparison between centers.

Keywords: Health service evaluation; Indicators; Patient safety; Psychiatry; Quality of care.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adult
Bipolar Disorder* / diagnosis
Bipolar Disorder* / therapy
Depressive Disorder, Major* / diagnosis
Depressive Disorder, Major* / therapy
Feasibility Studies
Female
Humans
Patient Safety / standards
Pilot Projects
Quality Indicators, Health Care*
Schizophrenia* / diagnosis
Schizophrenia* / therapy
Spain