Routine measurement of satisfaction with life and treatment aspects in mental health patients – the DIALOG scale in East London

Abstract

Aims The DIALOG scale has been implemented as a routine patient outcome and experience measure (PROM/PREM) in a mental health trust in East London since 2017. The resulting healthcare dataset was used to estimate satisfaction with life and treatment aspects over time and factors associated with it. Methods Variables available from the Trust were DIALOG items, service level, clinical and basic demographic data. Data was extracted in February 2019. Data is described using a range of descriptive statistics and looking at the subgroups: treatment stage, diagnosis, service type. Predictors for average DIALOG scores across patients was explored with clustered linear regression models. A fixed effect model was chosen to estimate the impact of clinical and service related variables on patient’s average DIALOG scores over time. Sensitivity analyses with the whole data set and complete cases were carried out. Results Of the original 18,481 DIALOG records 12, 592 were kept after data cleaning (5646 patients). The average DIALOG score was 4.8 (SD 1.0) on the 7-point scale. Average satisfaction with life aspects (PROM) was 4.65 (SD 1.1) and with treatment aspects (PREM) was 5.25 (SD 1.17). Across all 11 items, “job situation” scored lowest (mean 4.05) and “meetings with professionals” highest (mean 5.5). Satisfaction for all items increased over time (average increase 0.47). The largest increase was in “mental health” (0.94) and the smallest in “family relationships” (0.34). Conclusions Patients in mental healthcare services were “fairly satisfied” in both life and treatment aspects with improvements seen over time. These results will act as a benchmark for clinical services currently implementing DIALOG across the UK and inform local service developments.

Needs and Experiences in Psychiatric Treatment (NEPT)- Piloting a Collaboratively Generated, Initial Research Tool to Evaluate Cross-Sectoral Mental Health Services

“…Thomas et al (70) developed a PREM scale for evaluating the experiences of an emergency department, and, thus, depart from our project in their research aim. The DIALOG instrument incorporates both PROM and PREM items, the latter being only a few and rather broad in their scope (71). These only few examples, as well as our attempt of comparison, underscore the urgent need for collaborating with researchers with experiential expertise in the construction of PREM scales.…”

“…These only few examples, as well as our attempt of comparison, underscore the urgent need for collaborating with researchers with experiential expertise in the construction of PREM scales. As stated by various authors (4,71), user-oriented services may only develop if the instruments to evaluate them will be better grounded in their perspectives and experiences into the future.…”

The Peterborough Exemplar: a protocol to evaluate the impact and implementation of a new patient-centred, system-wide community mental healthcare model in England

“… Evaluation of service user and carer outcomes Routinely collected outcomes measures completed by service users accessing the Exemplar services and the secondary care specialist teams will be analysed pre- and post-treatment. Quality of life and care satisfaction of service users will be assessed using the DIALOG tool, an 11-item measure combining eight questions on satisfaction with quality of life and three on satisfaction with service provision [ 37 ]. A brief questionnaire with four further questions on service satisfaction and the impact of the COVID-19 pandemic is also included, as the Exemplar implementation began during the pandemic period.…”

Perspectives on psychedelic treatment and research in eating disorders: a web-based questionnaire study of people with eating disorders

“…An example of a PROM/PREM currently used in psychiatry is the DIALOG tool used in community mental health teams. Patients are asked to rate their satisfaction with different areas of their life [55]. However, there are currently no PROMs or PREMs for the psychopharmacological treatment of AN.…”