The effects of motivation feedback in patients with severe mental illness: a cluster randomized controlled trial

Eline C Jochems,1,2 Christina M van der Feltz-Cornelis,1–3 Arno van Dam,3,4 Hugo J Duivenvoorden,5 Cornelis L Mulder1,6 1Department of Psychiatry, Epidemiological and Social Psychiatric Research Institute, Erasmus MC University Medical Center, Rotterdam, the Netherlands; 2GGz Breburg, Top...

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Autores principales:	Jochems EC, van der Feltz-Cornelis CM, van Dam A, Duivenvoorden HJ, Mulder CL
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2015
Materias:	randomized controlled trial feedback motivation adherence psychotic disorders personality disorders Neurosciences. Biological psychiatry. Neuropsychiatry RC321-571 Neurology. Diseases of the nervous system RC346-429
Acceso en línea:	https://doaj.org/article/e11c685462dc40b39a323a41e6b99eb8
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spelling	oai:doaj.org-article:e11c685462dc40b39a323a41e6b99eb82021-12-02T01:03:02ZThe effects of motivation feedback in patients with severe mental illness: a cluster randomized controlled trial1178-2021https://doaj.org/article/e11c685462dc40b39a323a41e6b99eb82015-12-01T00:00:00Zhttps://www.dovepress.com/the-effects-of-motivation-feedback-in-patients-with-severe-mental-illn-peer-reviewed-article-NDThttps://doaj.org/toc/1178-2021Eline C Jochems,1,2 Christina M van der Feltz-Cornelis,1–3 Arno van Dam,3,4 Hugo J Duivenvoorden,5 Cornelis L Mulder1,6 1Department of Psychiatry, Epidemiological and Social Psychiatric Research Institute, Erasmus MC University Medical Center, Rotterdam, the Netherlands; 2GGz Breburg, Top Clinical Center for Body, Mind and Health, Tilburg, the Netherlands; 3Tilburg University, Faculty of Social Sciences, Tranzo Department, Tilburg, the Netherlands; 4GGZ Westelijk Noord Brabant, Bergen op Zoom, the Netherlands; 5Erasmus MC University Medical Center, Rotterdam, the Netherlands; 6BavoEuropoort, Parnassia Psychiatric Institute, Rotterdam, the Netherlands Objective: To evaluate the effectiveness of providing clinicians with regular feedback on the patient’s motivation for treatment in increasing treatment engagement in patients with severe mental illness.Methods: Design: cluster randomized controlled trial (Dutch Trials Registry NTR2968). Participants: adult outpatients with a primary diagnosis of a psychotic disorder or a personality disorder and their clinicians, treated in 12 community mental health teams (the clusters) of two mental health institutions in the Netherlands. Interventions: monthly motivation feedback (MF) generated by clinicians additional to treatment as usual (TAU) and TAU by the community mental health teams. Primary outcome: treatment engagement at patient level, assessed at 12 months by clinicians. Randomization: teams were allocated to MF or TAU by a computerized randomization program that randomized each team to a single treatment by blocks of varying size. All participants within these teams received similar treatment. Clinicians and patients were not blind to treatment allocation at the 12-month assessment.Results: The 294 randomized patients (148 MF, 146 TAU) and 57 clinicians (29 MF, 28 TAU) of 12 teams (6 MF, 6 TAU) were analyzed according to the intention-to-treat principle. No statistically significant differences between treatment groups on treatment engagement were found (adjusted mean difference =0.1, 95% confidence interval =-2.2 to 2.3, P=0.96, d=0). Preplanned ancillary analyses showed statistically significant interaction effects between treatment group and primary diagnosis on treatment motivation and quality of life (secondary outcomes), which were beneficial for patients with a primary diagnosis of a personality disorder but not for those with a psychotic disorder. There were no reports of adverse events.Conclusion: The current findings imply that monitoring and discussing the patient’s motivation is insufficient to improve motivation and treatment engagement, and suggests that more elaborate interventions for severe mental illness patients are needed. Keywords: randomized controlled trial, feedback, motivation, adherence, psychotic disorders, personality disordersJochems ECvan der Feltz-Cornelis CMvan Dam ADuivenvoorden HJMulder CLDove Medical Pressarticlerandomized controlled trialfeedbackmotivationadherencepsychotic disorderspersonality disordersNeurosciences. Biological psychiatry. NeuropsychiatryRC321-571Neurology. Diseases of the nervous systemRC346-429ENNeuropsychiatric Disease and Treatment, Vol 2015, Iss Issue 1, Pp 3049-3064 (2015)
institution	DOAJ
collection	DOAJ
language	EN
topic	randomized controlled trial feedback motivation adherence psychotic disorders personality disorders Neurosciences. Biological psychiatry. Neuropsychiatry RC321-571 Neurology. Diseases of the nervous system RC346-429
spellingShingle	randomized controlled trial feedback motivation adherence psychotic disorders personality disorders Neurosciences. Biological psychiatry. Neuropsychiatry RC321-571 Neurology. Diseases of the nervous system RC346-429 Jochems EC van der Feltz-Cornelis CM van Dam A Duivenvoorden HJ Mulder CL The effects of motivation feedback in patients with severe mental illness: a cluster randomized controlled trial
description	Eline C Jochems,1,2 Christina M van der Feltz-Cornelis,1–3 Arno van Dam,3,4 Hugo J Duivenvoorden,5 Cornelis L Mulder1,6 1Department of Psychiatry, Epidemiological and Social Psychiatric Research Institute, Erasmus MC University Medical Center, Rotterdam, the Netherlands; 2GGz Breburg, Top Clinical Center for Body, Mind and Health, Tilburg, the Netherlands; 3Tilburg University, Faculty of Social Sciences, Tranzo Department, Tilburg, the Netherlands; 4GGZ Westelijk Noord Brabant, Bergen op Zoom, the Netherlands; 5Erasmus MC University Medical Center, Rotterdam, the Netherlands; 6BavoEuropoort, Parnassia Psychiatric Institute, Rotterdam, the Netherlands Objective: To evaluate the effectiveness of providing clinicians with regular feedback on the patient’s motivation for treatment in increasing treatment engagement in patients with severe mental illness.Methods: Design: cluster randomized controlled trial (Dutch Trials Registry NTR2968). Participants: adult outpatients with a primary diagnosis of a psychotic disorder or a personality disorder and their clinicians, treated in 12 community mental health teams (the clusters) of two mental health institutions in the Netherlands. Interventions: monthly motivation feedback (MF) generated by clinicians additional to treatment as usual (TAU) and TAU by the community mental health teams. Primary outcome: treatment engagement at patient level, assessed at 12 months by clinicians. Randomization: teams were allocated to MF or TAU by a computerized randomization program that randomized each team to a single treatment by blocks of varying size. All participants within these teams received similar treatment. Clinicians and patients were not blind to treatment allocation at the 12-month assessment.Results: The 294 randomized patients (148 MF, 146 TAU) and 57 clinicians (29 MF, 28 TAU) of 12 teams (6 MF, 6 TAU) were analyzed according to the intention-to-treat principle. No statistically significant differences between treatment groups on treatment engagement were found (adjusted mean difference =0.1, 95% confidence interval =-2.2 to 2.3, P=0.96, d=0). Preplanned ancillary analyses showed statistically significant interaction effects between treatment group and primary diagnosis on treatment motivation and quality of life (secondary outcomes), which were beneficial for patients with a primary diagnosis of a personality disorder but not for those with a psychotic disorder. There were no reports of adverse events.Conclusion: The current findings imply that monitoring and discussing the patient’s motivation is insufficient to improve motivation and treatment engagement, and suggests that more elaborate interventions for severe mental illness patients are needed. Keywords: randomized controlled trial, feedback, motivation, adherence, psychotic disorders, personality disorders
format	article
author	Jochems EC van der Feltz-Cornelis CM van Dam A Duivenvoorden HJ Mulder CL
author_facet	Jochems EC van der Feltz-Cornelis CM van Dam A Duivenvoorden HJ Mulder CL
author_sort	Jochems EC
title	The effects of motivation feedback in patients with severe mental illness: a cluster randomized controlled trial
title_short	The effects of motivation feedback in patients with severe mental illness: a cluster randomized controlled trial
title_full	The effects of motivation feedback in patients with severe mental illness: a cluster randomized controlled trial
title_fullStr	The effects of motivation feedback in patients with severe mental illness: a cluster randomized controlled trial
title_full_unstemmed	The effects of motivation feedback in patients with severe mental illness: a cluster randomized controlled trial
title_sort	effects of motivation feedback in patients with severe mental illness: a cluster randomized controlled trial
publisher	Dove Medical Press
publishDate	2015
url	https://doaj.org/article/e11c685462dc40b39a323a41e6b99eb8
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The effects of motivation feedback in patients with severe mental illness: a cluster randomized controlled trial

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