Evidence Brief: Use of Patient Reported Outcome Measures for Measurement Based Care in Mental Health Shared Decision-Making

Measurement based care (MBC) is a care delivery approach involving the regular use of standardized measures in routine mental health care to identify individuals not improving as expected and to prompt treatment changes. In the US Department of Veterans Affairs (VA), MBC is specifically defined as: (1) Collect = use of “reliable, validated, clinically appropriate measures at intake and at regular intervals”, (2) Share = “results from the measures are immediately shared and discussed with the Veteran and other providers involved in the Veteran’s Care”, and (3) Act = “Together, providers and Veterans use outcome measures to develop treatment plans, assess progress over time, and inform shared decisions about changes to the treatment plan over time”. As of January 2018, the Joint Commission requires MBC use in all mental health treatment programs accredited under behavioral health standards both within and outside of VA. As MBC delivery has varied widely and shown equally variable clinically meaningful effects across studies, guidance is needed on which specific delivery approaches may operate most effectively and why. This rapid evidence synthesis builds on recent conflicting reviews by adding 14 new studies and focusing on the subset of approaches with the most clinically meaningful and highest-strength evidence and with the most relevance to the specific approach currently recommended by VA.