Study will compare effectiveness of patient-centered and measurement-based behavioral treatments

A three-year study by UPMC’s Center for High-Value Health Care to determine whether a model of patient-centered treatment for people with serious mental illnesses is more effective than measurement-based treatment has been approved for $2.1 million in funding by the Patient-Centered Outcomes Research Institute (PCORI). PCORI is an organization created by the Affordable Care Act to fund and share research that compares the clinical effectiveness of evidence-based approaches to care to help providers, caregivers and patients make better care choices.

The study - "Amplifying the Patient's Voice: Person-Centered Versus Measurement-Based Approaches in Mental Health" - builds on prior work with the “shared decision making” approach done by Community Care Behavioral Health Organization (Community Care) with the approach’s developer, Patricia Deegan, Ph.D. The study will involve up to 3,000 adults who have Medicaid as their health insurance and receive medication treatment at one of 14 community mental health clinics across Pennsylvania.

"Shared decision making is a strategy that could improve the interaction between providers and people with serious mental health conditions," said principal investigator, Kim MacDonald-Wilson, Sc.D., of the UPMC Center for High-Value Health Care, who is an adjunct assistant professor of psychiatry at the University of Pittsburgh School of Medicine and Senior Director of Recovery and Wellness Transformation at Community Care. "Our study will explore how technology can be used in the care process to amplify the voice of the person in care, support shared decision making, and improve patient-centered outcomes."

Funds for the three-year study will be shared by the UPMC Center for High-Value Health Care with the partners on the contract:  Community Care, the largest not-for-profit behavioral health managed care organization in the country; Pat Deegan PhD & Associates, LLC, an organization committed to creating and disseminating technologies to support the recovery of people diagnosed with mental illness; and the Dartmouth Psychiatric Research Center.

Fifteen minutes is the typical length of an outpatient medication management appointment for people with serious mental health conditions. These brief interactions with prescribers are often provider-driven and little time is spent focusing on the patient's individual needs and personal recovery. Shared decision making is considered to be a strategy that could improve the interaction, although little is known about its impact on outcomes that matter most to patients with serious mental illness. This study will compare two evidence-based, technology-supported strategies to determine which works best for individuals with serious mental illness and under what circumstances.

PCORI made grants to 65 health-related agencies in 23 states and Washington, D.C., and Quebec, in 2013. Since 2011, it has disbursed more than $460 million to fund healthcare related comparative effectiveness research.