Using patient-reported outcome measures for program evaluation: Design and findings on intention-to-treat outcomes from the Veterans Outcome Assessment survey

Psychiatry Res. 2020 Sep:291:113226. doi: 10.1016/j.psychres.2020.113226. Epub 2020 Jun 18.

Abstract

The Veterans Outcomes Assessment (VOA) program surveys Veteran Health Administration (VHA) patients when they begin mental health treatment and at follow-up at three months to obtain patient-reported outcomes measures (PROM). It complements VA's evolving program in measurement-based care by providing additional data that can be useful for program evaluation including assessments of patients who have not been seen for ongoing mental health care. In principle, it provides data on intention-to-treat outcomes for program evaluation to complement the outcomes for patients who are receiving ongoing treatment that can be derived from measurement-based care. VOA findings confirm differences in outcomes between patients who have continued to be seen for treatment and those who have not. Patients in general mental health clinics with no encounters between the baseline and follow-up assessments who reported discontinuing care because they did not want or need treatment improved more, and those who discontinued due to problems improved less than those who remained in treatment. Experience with VOA has identified a number of issues that must be addressed before it is possible to use intention-to-treat outcomes for program evaluation.

Keywords: Intention to treat outcomes; Mental health; Patient reported outcomes; Program evaluation; Veterans.

Publication types

  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Adult
  • Aged
  • Female
  • Follow-Up Studies
  • Humans
  • Intention to Treat Analysis / standards*
  • Intention to Treat Analysis / trends
  • Male
  • Middle Aged
  • Outcome Assessment, Health Care / standards*
  • Outcome Assessment, Health Care / trends
  • Patient Reported Outcome Measures*
  • Program Evaluation / standards*
  • Program Evaluation / trends
  • Psychotherapy / standards
  • Psychotherapy / trends
  • Surveys and Questionnaires / standards*
  • United States / epidemiology
  • United States Department of Veterans Affairs / trends
  • Veterans* / psychology