Creation of an Actionable Knowledge Toolkit for Evidence-Based Psychiatric Care

Objectives

Measurement-based care (MBC) refers to using data from assessments to make clinical decisions. Recently the Relapse Assessment for Schizophrenia Patients (RASP), a patient self-report screener, was developed, but uptake may be limited by lack of guidance. The purpose of this study is to develop an actionable knowledge toolkit (AKT) to facilitate use of the RASP.

Methods

To inform AKT creation, a literature review examined benefits of MBC, recommendations for successful implementation, causes/warning signs of relapse, and existing measures/ interventions to identify/prevent relapse in schizophrenia. In addition, clinician focus groups were convened using purposive stratified assignment to assess specific barriers and recommend specific training materials for the RASP AKT.

Results

The literature review revealed research on MBC effectiveness is robust, but information about the impact of MBC on relapse prevention/intervention in schizophrenia is scarce, as is information about clinical training and implementation support tools for relapse risk prediction and prevention. Focus group feedback regarding the RASP was favorable but stressed the need for workflow considerations. For development of the AKT, participants requested increased training during onboarding, the need for online training about schizophrenia and psychotherapy/treatments and ongoing implementation support to facilitate long-term adoption of the RASP. Participants indicated a need for electronic medical record integration of MBC tools and additional psychoeducation resources for clients/families.

Next Steps

The AKT will be completed and tested against intervention as usual in a study including 150 clinicians across a large behavioral health treatment system to assess the effectiveness of the AKT in promoting MBC.