Effectiveness of the implementation of guidelines for anxiety disorders in specialized mental health care

Acta Psychiatr Scand. 2015 Jul;132(1):69-80. doi: 10.1111/acps.12338. Epub 2014 Sep 22.

Abstract

Objective: To examine the effect of implementing anxiety disorders guidelines on guideline adherence and patient outcomes in specialized mental health care.

Method: A treatment setting in which guidelines were implemented (intervention condition) was compared with one in which guidelines were only disseminated (control condition).

Results: Of 61.7% of 81 intervention-condition patients received treatment according to the guidelines vs. 40.6% of 69 control-condition patients (P = 0.01). At 1-year follow-up, intervention-condition patients showed a greater decrease in anxiety symptoms (d = 0.48, P < 0.05); higher percentages of response (52.6% vs. 33.8%; P = 0.025) and remission (33.3% vs.16.9%; P = 0.026); and a greater decrease in the rate of phobic avoidance (d = 0.34, P < 0.05). At 2-year follow-up, control-condition patients had experienced a longer period of treatment, which had eroded most of these differences, except for phobic avoidance.

Conclusion: Systematic guideline implementation results in earlier gains and shorter treatment times.

Keywords: anxiety; health-care services; outcome; treatment.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Antidepressive Agents / therapeutic use
  • Anxiety Disorders / therapy*
  • Behavior Therapy / methods
  • Case-Control Studies
  • Cohort Studies
  • Female
  • Guideline Adherence / statistics & numerical data*
  • Health Plan Implementation / statistics & numerical data*
  • Humans
  • Male
  • Mental Health Services / organization & administration*
  • Practice Guidelines as Topic*
  • Treatment Outcome

Substances

  • Antidepressive Agents