Using feedback from patient-reported outcome measures in mental health services: A scoping study and typology

Objective: Routine evaluation of mental health services has become widespread, and the use of patient-reported outcome measures (PROMs) as clinical aids or discussion tools has been receiving increasing attention. The purpose of this scoping study is to provide a typology of the diverse ways in which studies reporting on PROM use in mental health services have utilized PROMs. Methods: Iterative scoping searches of the literature identified articles reporting on the use of PROM feedback in mental health settings, which were then categorized to develop a typology along a dimension of intensity of PROM feedback, ranging from no feedback to patient and clinician to clinician-patient discussion that followed a formalized structure. Results: Of the 172 studies that were identified, 27 were grouped into five categories, ranging from no PROMs feedback to either clinician or patient to studies in which a formalized structure was available by which PROM feedback could be discussed between clinician and patient. Of the 11 studies in the category with formalized feedback, nine studies reported some significant effects of feedback compared to a control condition, and two reported partial effects. Conclusions: The proposed procedural typology helps explain the diversity of results from studies reporting on the effects of PROM feedback, by highlighting that PROM feedback appears to be more effective when integrated in a formalized and structured manner. Future work is required to isolate these effects from common procedural correlates, such as monitoring of therapeutic alliance.