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At least 19 recordsLinked to original sources
PubMed1991

Assessment of treatment outcome.

Treatment outcome research consists of two types: controlled clinical trials and in-house program evaluations. Controlled clinical trials are experimental studies designed to test whether or not a treatment is efficacious. In-house program evaluations provide information about the results (outcome) of an individual treatment program. The key components of clinical trials include control groups; randomization procedures; enumeration of those who were screened for inclusion in, those accepted into, and those excluded from the study; a description of the relevant patient characteristics of the sample studied; "double-blinding" for pharmacological studies; raters of treatment effects who are not the therapists for verbal therapies; objective measures of treatment response; follow-up of at least 70% of the original sample; and appropriate statistical analysis of the data collected. In-house program evaluations rarely have control groups or employ randomization. However, a description of the type of patients treated by the program, independent raters, and adequate follow-up of those entering treatment are essential for program evaluation; and the credibility of program evaluation would be enhanced by the use of objective measures of treatment response.

Alcoholism↗
PubMed1987

Lithium carbonate treatment of mania. Cerebrospinal fluid and urinary monoamine metabolites and treatment outcome.

Treatment of manic patients with lithium carbonate was associated with significant decreases in cerebrospinal fluid (CSF) 3-methoxy-4-hydroxyphenylglycol (MHPG) and urinary norepinephrine excretion. These measures, before treatment, were higher in manic patients than in either depressed or normal subjects and correlated significantly with severity of mania. Levels in CSF of homovanillic acid and 5-hydroxyindoleacetic acid did not correlate with severity or with change during lithium carbonate treatment. Responders (about 70% of the patients) did not differ from nonresponders in pretreatment mania ratings or neurotransmitter measures. The CSF MHPG and urinary norepinephrine excretion were reduced during lithium carbonate treatment in both responders and nonresponders. Unlike the case before treatment, urinary MHPG excretion was higher during treatment in nonresponders than in responders and correlated with several indexes of symptom severity. These results support a relationship between mania and increased noradrenergic function. Treatment outcome, however, was not related exclusively to the reduction of noradrenergic indexes by lithium carbonate since reductions were similar in both responders and nonresponders. Reduced noradrenergic activity may therefore be necessary but not sufficient for successful outcome during lithium carbonate treatment.

Adult↗
PubMed1990

Health locus of control beliefs and alcohol-related factors that may influence treatment outcomes.

Treatment programs have based their treatment approach on the premise that alcoholics should exert internal control over situations and events that affect them. Since chronic alcohol use affects the health of an individual, Walston and Walston's Multidimensional Health Locus of Control Scale was administered to 47 alcoholics in a treatment program. The population reflected a higher belief that health status is more under their own control than under the control of chance or powerful others. However, the results indicated that recovering alcoholics with a more powerful other health orientation tended to maintain membership longer with Alcoholics Anonymous, would seek help sooner, would begin heavy drinking at a later age, and would attempt formal treatment more often.

Adolescent↗
PubMed1990

Personality disorders and treatment outcome in the NIMH Treatment of Depression Collaborative Research Program.

The authors investigated the relationship between personality disorders and treatment outcome in the National Institute of Mental Health Treatment of Depression Collaborative Research Program, which involved 239 outpatients with major depressive disorder randomly assigned to one of four 16-week treatment conditions. Patients with personality disorders (74% of the sample) had a significantly worse outcome in social functioning than patients without personality disorders and were significantly more likely to have residual symptoms of depression. There were no significant differences in work functioning or in mean depression scores at treatment termination. Outcome was similar for patients in the different clusters of personality disorders.

Adult↗
PubMed1986

MMPI and headache: a special focus on differential diagnosis, prediction of treatment outcome, and patient-treatment matching.

The relation between personality characteristics and the psychological functioning of headache patients has long been a topic of interest. Early investigations focused on clinical and anecdotal reports while recent research has moved toward a more objective evaluation of headache groups by using the MMPI. However, the findings from diverse studies have not been integrated, nor has a rationale for the use of these data in the clinical management of headache been formally presented. The focus of this review is to present a concise, integrated analysis of previous group MMPI headache studies and apply these findings to differential diagnosis, prediction of treatment outcome, and client-treatment matching. Five selected clinical case studies indicating various degrees of psychopathology in migraine headache patients are presented to highlight treatment issues in support of an idiographic utilization of the MMPI for the clinical treatment of headache patients.

Adult↗
PubMed1987

Eliciting preferences for alternative drug therapies in oncology: influence of treatment outcome description, elicitation technique and treatment experience on preferences.

Several methodologic issues arise in eliciting preferences for therapy. Examples are the selection of appropriate descriptions of treatment outcomes and of elicitation techniques. Of particular importance is the correspondence of patients' anticipated preferences for treatment to actual preferences once they have experienced treatment. Treatment outcome descriptions and elicitation techniques were compared for a hypothetical drug decision problem involving trade-offs between quality and quantity of life. Preferences of 54 cancer patients were elicited before, and 6 weeks following initiation of chemotherapy treatment. Patients' preferences were not influenced by the way information about side effects was presented, nor the stated probability of survival at high and moderate levels. A riskless rating technique produced different preferences from those of a risky treatment choice method. Although patients experienced significant toxicity following initiation of treatment, their preferences remained stable on retest. The results raise questions about the extent to which patients are willing, at the time of decision making, to trade off survival rate for improved quality of life.

Antineoplastic Agents↗
PubMed1990

Neglected factors in chronic pain treatment outcome studies--referral patterns, failure to enter treatment, and attrition.

An increasing number of chronic pain treatment outcome studies have appeared in the literature. In general, these studies support the efficacy of multidisciplinary pain programs, as well as specific treatment modalities such as biofeedback and relaxation. Reviews of this literature have tended to be cautiously optimistic. Some concerns, however, have been raised about the methodological adequacy of these studies, particularly in terms of the lack of control groups, the brief duration of follow-up periods, and the vague criteria used for establishing the success of the therapeutic interventions. Other factors that mitigate conclusions regarding the generalizability of the favorable results reported need to be considered. In this paper 3 rarely discussed topics that are implicit within most treatment outcome studies and that need to be given greater attention are examined. These topics include: (1) referral patterns to pain clinics (who are referred to pain clinics, when, and how representative is the referred sample?); (2) failure to enter treatment (e.g., exclusion criteria, lack of available financial support to cover the cost of treatment, patient's refusal to accept recommendations), and consequently, the representativeness of the treated sample; and (3) patient's attrition. In this paper we discuss each of these factors as they underscore important qualifications that have to be made in evaluating treatment outcome studies.

Chronic Disease↗
PubMed1991

The effect of delay on treatment outcome in altitude-induced decompression sickness.

Records at the USAF School of Aerospace Medicine, Hyperbaric Medicine Division, were reviewed to determine whether a relationship exists between the length of time from development of symptoms of altitude chamber decompression sickness (DCS) to start of compression therapy and the outcome of treatment. During the 5-year period from 1 January 1984 to 31 December 1988, 233 cases of altitude chamber DCS were treated in USAF hyperbaric chambers. Information obtained from each record included age, sex, time from exposure to symptom onset, time from symptom onset to start of compression therapy, time required for resolution of symptoms, and number of treatment failures (failure to resolve during the first treatment dive or recurrence of symptoms after the first dive). Analysis of the data obtained from treatment records reveals a direct relationship between length of delay to treatment with compression therapy and outcome of treatment. Patients successfully treated with a single treatment dive had an average delay to treatment of 10.6 h. Patients that failed treatment after one dive (failed to resolve or recurred) had an average delay to treatment of 18.2 h. The difference between these groups is significant (p less than 0.05). Outcome of treatment was not significantly related to patient age, sex, or type of symptoms. A discussion of factors causing delays in treatment of decompression sickness is included.

Adult↗
PubMed1986

Process of change during social skills training with preadolescents and its relation to treatment outcome.

Videotaped excerpts of treatment sessions from a recent intervention study were examined to explore the changes occurring during social skills training and their relation to treatment outcome. 27 unpopular preadolescents who showed few conversational skills during pretreatment observations engaged in cooperative activities with 2 socially accepted classmates for 10 half-hour sessions. Half of these triads received coaching in conversational skills, while the others received nonspecific adult support during these activities. The quality of social interactions among triad members was evaluated during the sixth and tenth sessions. Children who received social skills training displayed more conversational skills and received more positive peer support during treatment than children who did not receive coaching. Coached children increased skill performance over time while noncoached children did not change. Furthermore, both conversational skills displayed and positive peer responses received during treatment sessions were positively related to treatment outcome.

Behavior Therapy↗
PubMed2026

Assessing the Concurrent Validity of the Australian Treatment Outcomes Profile in a Methamphetamine Dependent Treatment-Seeking Population.

INTRODUCTION: The Australian Treatment Outcomes Profile (ATOP) is a brief clinical tool assessing substance use, health and well-being used in Australian alcohol and other drug treatment services. It is validated for use with clients using alcohol, opioids and cannabis, but not yet for clients who primarily use methamphetamine. METHODS: An embedded validation study was undertaken in treatment-seeking adults enrolled in a randomised double-blind placebo-controlled trial of lisdexamfetamine for methamphetamine dependence with sites in New South Wales, South Australia and Victoria. Participant demographics were collected during study screening. The ATOP and comparators (Time Line Follow Back, Opiate Treatment Index, Depression Anxiety Stress Scale, WHOQOL-BREF and Personal Wellbeing Index) were collected at baseline. Continuous ATOP items were analysed using Pearson's correlation coefficient, and dichotomous items were analysed using Fleiss's &#x3ba;. Agreement was rated as strong where measures were &#x2265;&#x2009;0.50, moderate where agreement was 0.30-0.49, and weak where <&#x2009;0.30. RESULTS: One hundred and eighteen study participants (2018-2020) had data for concurrent validity analysis. Strong validity was demonstrated for physical health, psychological health, quality of life, injecting drug use and crime items, and for days of use for amphetamines, alcohol, cannabis and cocaine. There was weak validity for days of use for benzodiazepines. Heroin use days and other opioid use days were endorsed by fewer than five participants and were therefore unable to be assessed. DISCUSSION AND CONCLUSIONS: The ATOP is valid for use in a treatment-seeking methamphetamine-dependent population, expanding the range of tools for assessment and standardised outcome monitoring across different settings and services.

Humans↗
PubMed1988

Predicting treatment outcome of chronic back pain patients in a multidisciplinary pain clinic: methodological issues and treatment implications.

Treatment outcome of 72 chronic back pain patients was assessed with 4 standardized measures: the McGill Pain Questionnaire, the Audiovisual Taxonomy of Pain Behavior, the Beck Depression Inventory, and the Profile of Mood States. Patients were also rated by their primary nurse on pain behavior, activity, drug-seeking, and sleep. Variables used to predict scores on outcome measures included patients' demographics and MMPI scores. Multiple regression analyses indicated that patients receiving worker's compensation engaged in more pain behavior and rated their pain as more severe, both upon admission and discharge from the pain program. High scores on the MMPI Hy scale were correlated with high self-ratings of pain and several MMPI scales correlated with negative mood. Even though demographic variables predicted admission and discharge scores on a number of treatment outcome measures, there was no relation between demographics and patients' improvement on treatment outcome measures. Patients with high scores on MMPI Hy and D scales displayed greatest admission to discharge improvement on self-rated pain and mood. Results were integrated with findings from previous studies. It was suggested that by distinguishing between overall scores on treatment outcome measures and improvement on these measures, professionals will be in a better position to devise individualized treatment plans for pain patients.

Adult↗
PubMed1987

Factors influencing treatment outcome and patient satisfaction in a short-term psychiatric ward. A path analysis study of the importance of patient involvement in treatment planning.

Factors influencing treatment outcome and patient satisfaction in a short-term psychiatric treatment programme were analysed using a path analysis method. The programme used two models of treatment planning, one with and one without active participation of the patient in formulating a written treatment contract. A causal structural model, which explained 23% of the variance in the model, was used in the final analysis. The results indicated a positive relationship between a cooperation contract procedure and the level of expectations of improvement as well as high ratings of the importance of the patients own effort in treatment. The level of expectations of improvement were related to the symptom level at discharge and global improvement during treatment, indicating a better treatment outcome for the patients of the cooperation contract group, while the importance of own effort was not related to treatment outcome. Symptoms at discharge were mainly determined by symptoms at admission and global improvement, and also by expectations of improvement, initial psychic status and social background. The explained variance was 63%. Satisfaction with treatment was mainly determined by global improvement, symptoms at discharge and expectations of improvement. The explained variance was 60%. It is concluded that attention to patient expectations of improvement viewed as an important intermediate variable, is related to a an improvement in treatment outcome.

Adult↗
PubMed1992

Predictors of short-term treatment outcome in bulimia nervosa inpatients.

Recent studies, mostly performed on bulimic outpatients, did not find consistent predictors of treatment outcome in bulimia nervosa. This is the first study to investigate anamnestic and clinical factors predictive of the short-term outcome of hospital treatment in 31 female bulimia nervosa patients with a mean age of 22.9 yr. Treatment outcome was assessed by several self-rating instruments measuring different features of the specific and unspecific psychopathology of bulimia nervosa. The most relevant predictors of the outcome of the 8-week hospital treatment were duration of previous inpatient treatments for bulimia, the intensity of anorexic tendency and the pretreatment level of depression. The majority of predictors tested did not show a strong relationship to treatment outcome. The findings are discussed in relation to results of other studies as well as to possible implications for treatment and research.

Adult↗
PubMed1988

Locus of control, life events and treatment outcome in alcohol dependent patients.

We investigated the relationship of locus of control and life events to outcome of treatment at 6 months in 67 patients with alcohol dependence. Outcome was less favourable in patients with pre-treatment scores indicating external locus of control than in those with internal locus of control. Furthermore, patients with relapse in the follow-up period experienced more independent life events with moderate to severe objective negative impact than those with more favourable outcome. These results suggest that locus of control may be of clinical use in formulating treatment and prognosis, and that the occurrence of life events may influence outcome. The results are discussed in relation to strategies for treatment and prevention of relapse.

Adult↗
PubMed1990

Depressed outpatients' life contexts, amount of treatment, and treatment outcome.

This paper examines the influence of life context factors and the amount of treatment on treatment outcome after 1 year among 265 unipolar depressed outpatients. Preintake medical conditions, family conflict, and lack of family support predicted poorer treatment outcome. Moreover, patients' family conflict and confidant support at intake interacted with the amount of treatment to influence outcome. Patients who had a close confidant and less family conflict showed better outcome with brief therapy; patients who lacked a confidant and had more family conflict experienced better outcome with longer treatment. Posttreatment stressors and lack of social resources were associated with poorer treatment outcome. The findings imply that treatment can provide temporary support to compensate for a lack of social resources. More intensive treatment may be needed for patients who experience more family conflict and who have a poor relationship or no relationship with a confidant.

Depression↗
PubMed1986

The relationship of drug program environmental variables to treatment outcome.

The Moos Community Oriented Program Environment Scale (COPES) was administered to 244 adolescent clients and 131 drug counselors in 30 "drug-free" outpatient drug treatment programs. Four of the COPES factor scores were found to predict significantly to treatment outcome (as measured by reduction in drug use): client ratings of "Spontaneity", and staff ratings of "Personal Problem Orientation", "Practical Problem Orientation", and "Order and Organization". The more positive the ratings of the program environments, the greater the reduction in client-reported drug use from admission to discharge. The "discrepancies" (differences) between staff and client perceptions of the programs on two of the COPES factors ("Autonomy" and "Staff Control") were also found to predict significantly to treatment outcome (as measured by reduction in drug use). The greater the discrepancy, the less successful was the treatment outcome. In the programs in which the clients tended to perceive the staff as less encouraging of client autonomy and as exercising more control over the clients relative to the staff's perceptions of these relationships, the clients tended to have less successful treatment outcomes. One possible interpretation of this finding might be that in the programs which have client populations that are more poorly motivated and more resistant to treatment, the clients will not only tend to have poorer treatment outcomes but will also perceive the program environment more negatively and thus will tend to disagree more with the staff's perceptions of the program.

Adolescent↗
PubMed1986

Response of thyrotropin to thyrotropin-releasing hormone as predictor of treatment outcome. Prediction of recovery and relapse in treatment with antidepressants and neuroleptics.

We determined whether the response of thyrotropin (TSH) to thyrotropin-releasing hormone could predict the outcome of treatment with antidepressant and neuroleptic drugs. We studied 114 female patients diagnosed as having major and minor depressive, manic, schizoaffective, and schizophrenic disorders. A blunted TSH response (less than 5 microU/mL [less than 5 mU/L]) at admission was associated with recovery after nine weeks of inpatient treatment using clomipramine hydrochloride for depression and haloperidol for psychosis. A blunted TSH response at discharge was associated with early relapse in depressives receiving clomipramine maintenance therapy. Our findings support the notion that the thyrotropin-releasing hormone test is a "state" marker that may be of use in predicting the outcome of treatment with antidepressant and neuroleptic drugs.

Adolescent↗