期刊
BEHAVIOUR RESEARCH AND THERAPY
卷 79, 期 -, 页码 15-22出版社
PERGAMON-ELSEVIER SCIENCE LTD
DOI: 10.1016/j.brat.2016.02.003
关键词
IAPT; Patient profiling; Risk stratification; Depression; Anxiety
资金
- Leeds Community Healthcare NHS Trust, United Kingdom
- NHS Research Ethics Committee [10/H1306/68]
Background: This study aimed to identify patient characteristics associated with poor outcomes in psychological therapy, and to develop a patient profiling method. Method: Clinical assessment data for 1347 outpatients was analysed. Final treatment outcome was based on reliable and clinically significant improvement (RCSI) in depression (PHQ-9) and anxiety (GAD-7) measures. Thirteen patient characteristics were explored as potential outcome predictors using logistic regression in a cross-validation design. Results: Disability, employment status, age, functional impairment, baseline depression and outcome expectancy predicted post-treatment RCSI. Regression coefficients for these factors were used to derive a weighting scheme called Leeds Risk Index (LRI), used to assign risk scores to individual cases. After stratifying cases into three levels of LRI scores, we found significant differences in RCSI and treatment completion rates. Furthermore, LRI scores were significantly correlated with the proportion of treatment sessions classified as 'not on track'. Conclusions: The LRI tool can identify cases at risk of poor progress to inform personalized treatment recommendations for low and high intensity psychological interventions. (C) 2016 Elsevier Ltd. All rights reserved.
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