改良协作评估与标准评估对患者心理治疗准备度影响的随机对照优越性试验（CO-ASM-RCT）结果。

IF 2 4区医学 Q3 MEDICINE, RESEARCH & EXPERIMENTAL Trials Pub Date : 2024-10-25 DOI:10.1186/s13063-024-08517-8

Oliver Rumle Hovmand, Nina Reinholt, Kirstine Dichmann, Radoslav Borisov, Carsten Hjorthøj, Sidse Arnfred

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引用次数: 0

摘要

背景：回避型人格障碍（AvPD）和社交恐惧症（SP回避型人格障碍（AvPD）和社交恐惧症（SP）与高昂的个人和社会成本有关。虽然心理治疗很有效，但许多患者在治疗过程中放弃了治疗。人们对如何提高患者接受心理治疗的意愿知之甚少。不过，研究强调，合作和治疗评估领域是提高心理治疗准备度的一种可能手段：我们进行了一项随机对照的可行性和优越性试验，对象是将在门诊心理健康服务机构开始心理治疗的 SP 或 AvPD 患者。患者按 1:1 的比例随机接受常规评估或改良协作评估（MCA），后者是在心理治疗开始前提供的治疗前干预措施。MCA 包括合作实施一系列心理测试，旨在更系统地评估患者的心理病理学。测试是与患者合作进行的，并提供详细的口头和书面反馈。我们调查了 MCA 干预在可接受性、患者满意度和坚持性方面的可行性。我们还调查了 MCA 对心理治疗准备度的影响（以罗德岛大学改变评估量表 (URICA) 进行评估），以及与症状和辍学率相关的结果：所有三个预设的可行性结果均符合要求。在治疗结束时，除了客户满意度有利于 MCA（- 7.42 (95% CI - 11.75; - 3.09; p = 0.002)）外，其他结果均无显著差异：讨论：我们发现 MCA 是可行的，患者对干预非常满意。讨论：我们发现 MCA 是可行的，患者对干预非常满意，因此有必要对 MCA 的另一种实施方法进行研究：试验注册：ClinicalTrials.gov NCT05018312。注册日期：2021 年 8 月 24 日。

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Results of a randomized controlled superiority trial of the effect of modified collaborative assessment vs. standard assessment on patients' readiness for psychotherapy (CO-ASSM-RCT).

Background: Avoidant personality disorder (AvPD) and social phobia (SP) are associated with high personal and societal costs. While psychotherapy can be efficient, many patients drop out during treatment. Little is known about what can be done to increase a patient's readiness for psychotherapy. However, research highlights the fields of collaborative and therapeutic assessment as a possible means to enhance readiness for psychotherapy.

Methods: We conducted a randomized controlled feasibility and superiority trial on patients with SP or AvPD who were to initiate psychotherapeutic treatment in outpatient mental health services. Patients were randomized 1:1 to either assessment as usual or modified collaborative assessment (MCA), provided as a pre-treatment intervention before psychotherapy initiation. MCA included the collaborative administration of a battery of psychological tests designed to assess the patient's psychopathology more systematically. The tests were administered in collaboration with the patient, and detailed oral and written feedback was provided. We investigated the feasibility of the MCA intervention regarding acceptability, patient satisfaction, and adherence. We also investigated MCA's effect on readiness for psychotherapy, as assessed with the University of Rhode Island Change Assessment Scale (URICA), and outcomes relating to symptomatology and dropout rates.

Results: All three prespecified feasibility outcomes were met. At the end of treatment, no significant difference was observed in any other outcome, except client satisfaction, which favored MCA (- 7.42 (95% CI - 11.75; - 3.09; p = 0.002)).

Discussion: We found that MCA was feasible, and patients were highly satisfied with the intervention. It is relevant to investigate another implementation of MCA.

Trial registration: ClinicalTrials.gov NCT05018312. Registered on August 24, 2021.

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来源期刊

Trials 医学-医学：研究与实验

CiteScore

3.80

自引率

4.00%

发文量

966

审稿时长

6 months

期刊介绍： Trials is an open access, peer-reviewed, online journal that will encompass all aspects of the performance and findings of randomized controlled trials. Trials will experiment with, and then refine, innovative approaches to improving communication about trials. We are keen to move beyond publishing traditional trial results articles (although these will be included). We believe this represents an exciting opportunity to advance the science and reporting of trials. Prior to 2006, Trials was published as Current Controlled Trials in Cardiovascular Medicine (CCTCVM). All published CCTCVM articles are available via the Trials website and citations to CCTCVM article URLs will continue to be supported.