Assessing schizophrenia QoL impact warranted
medwireNews: By assessing and evaluating the quality of life (QoL) of patients with schizophrenia, clinicians can significantly improve patient satisfaction, say researchers.
"This finding confirms the relevance of including QoL in clinical practice," the investigators led by Laurent Boyer (LA Timone University, Marseille, France) report.
However, they note that, despite having a positive effect on patient satisfaction, QoL assessment with feedback to the clinician did not significantly affect clinical outcomes, and may suggest "that clinicians did not optimally use these data."
They therefore recommend that "in addition to feedback, providing advice and guidelines regarding data interpretation and use is necessary to ensure that QoL data have direct implications for clinical practice."
A total of 124 middle-aged patients with mild schizophrenia were randomly assigned to receive standard psychiatric assessment, QoL assessment, or QoL assessment plus feedback, which involved assessment responses being evaluated and fed-back to the clinician for interpretation.
The QoL assessment comprised three questions: What is your degree of satisfaction regarding your global care management?; What is your degree of satisfaction regarding the care structure?; and What is your degree of satisfaction regarding the care staff?
At 6 months, significant differences were seen among the groups with regard to global satisfaction and satisfaction with the care structure. In particular, 72.5% of patients in the QoL assessment and feedback group reported high levels of satisfaction, compared with 67.5% of those receiving standard assessment, and 45.2% of those receiving QoL assessment without feedback.
The findings were similar at 3 months, with significant differences seen across all three domains. For example, a total of 75.0%, 68.3%, and 50.0% of patients in the QoL feedback, standard psychiatric, and QoL assessment groups, respectively, reported high levels of global satisfaction.
Clinical outcomes were better in the QoL feedback group than the other groups at 3 and 6 months, and more changes to medication were made in this group, but in both instances the differences were not significant.
The researchers suggest in The British Journal of Psychiatry that "quality of life measures may help to understand the subjective experiences that are key in treating people with mental disorders and improve patient-clinician communication."
They also highlight the "nocebo" effect in patients who QoL was assessed but without feedback.
"Measuring QoL may cause 'side-effects' through the exploration of sensitive subjects, thereby generating new expectations from clinicians on the part of the patients," they explain.
medwireNews (www.medwirenews.com) is an independent clinical news service provided by Springer Healthcare Limited. © Springer Healthcare Ltd; 2013
By Lucy Piper, Senior medwireNews Reporter