| Macpherson et al 1999 [45] |
To improve formal clinical goal setting through use of standardised CPA documentation. Outcome goals documented within meeting and agreed with all. Each patient (n = 139) offered copies of final typed CPA documentation. |
Overall 68% of goals were fully and 11% partially achieved. Goals targeting the drug treatment of psychiatric syndromes were most likely to be fully successful (84%) while approaches to self-care skills, side effects, physical/medical problems, family relationships, were moderately successful. Individual care planning can be combined with outcome measurement, to give a meaningful measure of the effectiveness of care. |
| Howells and Thompsell 2002 [46] |
eCPA—a computer-based system for better care planning and documentation. |
The eCPA was welcomed by staff. Patients welcomed the legibility and detail of the forms. Care plans were longer and more detailed, no longer constrained by the size of boxes on paper forms. Care plans were also adjusted more frequently by staff. |
| Lockwood & Marshall 1999 [47] |
“Needs feedback” technique as an intervention for improving CPA care planning and care delivery. |
Significant improvements were seen in the number of ‘unmet’ needs being identified. Improvements approaching significance were seen for social functioning and negative psychiatric symptoms, but not for positive psychiatric symptoms. This pilot study suggests that needs feedback may improve the quality of nursing assessment and care planning within the CPA. |
| Blenkiron et al 2003 [48] |
Carers’ & Users’ Expectation of Services—User version (CUES-U)—17 item service user outcomes scale in booklet form to be used by patients and professionals during care planning meetings. Covers the issues of quality of life that users rather than professionals have identified as priorities. |
CUES-U was an effective and practicable tool for increasing users’ involvement in their care. The CUES-U discussion led to a change in clinical care for 49% of respondents. Most professionals rated CUES-U as effective use of their time. Women and those with shorter duration mental disorders were rated as more engaged in the care planning consultation process. |
| Marshall et al 2004 [49] |
A standardised assessment of need and its impact on care planning effectiveness. |
The only significant effect of the intervention was on patient satisfaction. Patients cluster-randomised to receive feedback were more satisfied than controls, but patients individually randomised to receive feedback were not. Standardised needs assessment did not substantially enhance care planning. |
| Killaspy et al 2012 [50] |
The Mental Health Recovery Star (MHRS)—outcome measure rated collaboratively by staff and service users assessing 10 life domains. MHRS ratings are agreed following collaborative discussion between the service user and mental health worker |
The MHRS was relatively quick and easy to use and had good test-retest reliability, but interrater reliability was inadequate. Convergent validity suggests it assesses social function more than recovery. Concluded that the MHRS cannot be recommended as a routine clinical outcome tool. |
| Priebe et al 2015 [51] |
DIALOG+ was developed as a computer-mediated intervention, consisting of a structured assessment of patients’ concerns combined with a solution-focused approach to initiate change. |
Patients in the DIALOG+ arm had better quality of life scores at 3, 6 and 12 months. They also had significantly fewer unmet needs at 3 and 6 months, fewer general psychopathological symptoms at all time points and better objective social outcomes at 12 months. Overall care costs were lower in the intervention group. |
| Omer et al 2016 [52] |
This process evaluation explored the possible mechanisms underlying the changes seen during the DIALOG+ trial reported above. |
The thematic analysis of participants’ views demonstrates that DIALOG+ may have resulted in improvements to patients’ quality of life through addressing a specific concern and initiating positive change in that area. Among the theme regarding a comprehensive structure, participants reported that DIALOG+ focused the discussion on the main issues and ensured constructive actions were agreed especially in areas relating to accommodation and mental health needs, compared to the domains physical health and healthy lifestyles. |
| Quantitative |
RCT [49, 51]; Documentary review of treatment goals [45]; Evaluation/testing of intervention [46, 47, 48, 50] |
| Qualitative |
None |
| Qualitative and quantitative mixed methods |
Cluster RCT and focus groups of new intervention [52] |
