Measurement-based care implementation in a Veterans Affairs primary care-mental health integration program

Measurement-based care (MBC) in behavioral health is the systematic use of validated measurement tools to guide clinical decision making and collaborative treatment planning. Although benefits of MBC for clinicians and patients have been supported by research, it appears to be underutilized in clinical settings. This study examined the effectiveness of a MBC implementation plan informed by the theory of planned behavior in a large, integrated primary care program at a Veterans Affairs hospital over 18 months. Multiple methods, including self-report clinician data and aggregated clinic data, were used to examine change in clinician MBC-related behaviors over time. Results demonstrated both an increase in symptom measures administered per clinical encounter and per individual patient treated. Additionally, the ratio of individuals receiving at least one symptom rating measure to total number of patients treated decreased over time, demonstrating increased use of MBC by integrated primary care clinicians. Survey data demonstrated upward trends in administering measures at initial assessment and at treatment termination, and clinician attitudes toward MBC were generally positive. Results corroborate the theory of planned behavior as a model in which to guide systematic MBC implementation. MBC implementation challenges and recommendations are discussed. (PsycInfo Database Record (c) 2020 APA, all rights reserved).