The effects of a computerized clinical decision aid on clinical decision-making and guideline implementation in psychosis care

Introduction Clinicians in mental healthcare have few objective tools to identify and analyse their patient’s care needs. Clinical decision aids are tools that can support this process. Objectives This study examines whether 1) clinicians working with a clinical decision aid (TREAT) discuss more of their patient’s care needs compared to usual treatment, and 2) agree on more evidence-based treatment decisions. Methods Clinicians participated in consultations (n=166) with patients diagnosed with psychotic disorders from four Dutch mental healthcare institutions. Primary outcomes were measured with the modified Clinical Decision-making in Routine Care questionnaire and combined with psychiatric, physical and social wellbeing related care needs. A multilevel analysis compared discussed care needs and evidence-based treatment decisions between treatment as usual (TAU) before, TAU after and the TREAT-condition. Results First, a significant increase in discussed care needs for TREAT compared to both TAU conditions (b = 20.2, SE = 5.2, p = 0.00 and b = 15.8, SE = 5.4, p = 0.01) was found. Next, a significant increase in evidence-based treatments decisions for care needs was observed for TREAT compared to both TAU conditions (b = 16.7, SE = 4.8, p = 0.00 and b = 16.0, SE = 5.1, p = 0.01). Conclusions TREAT improved the discussion about physical health issues and social wellbeing related topics. It also increased evidence-based treatment decisions for care needs which are sometimes overlooked and difficult to treat. Our findings suggest that TREAT makes sense of ROM data and improves guideline-informed care. Disclosure No significant relationships.