Enhancing Clinical Depression Treatment Outcomes: A Comprehensive Approach using Measurement-based Care, Research Benchmarks, and Systematic Quality Improvements

Background Depression is a leading cause of global burden of disease. Evidence-based interventions, such as psychotherapy and pharmacotherapy, are effective in alleviating depressive symptoms; however, challenges regarding accessibility of good quality care persist. This study investigated a Continuous Quality Improvement (CQI) process that incorporated measurement-based care and benchmarking to enhance treatment outcomes for depression within specialized mental healthcare settings. Methods This study utilized data from two outpatient mental health clinics in Stockholm, Sweden. In a first step, the study employed patient-reported outcome measures (PROMs) to compare clinical treatment results with a meta-analytic benchmark (Öst et al. 2023). In a second step, a CQI framework was implemented to improve treatment outcomes. Results A total sample size of N = 415 patients treated for depression was included in the analyses. The clinical sample demonstrated higher pre-treatment depression severity scores, more appointments, and a lower data attrition rate compared to the meta-analytic benchmark. Year-to-year analyses indicated that clinical treatment effects were initially significantly lower (Hedge’s g  = 0.87 to 1.01, 95% CI[0.58–1.16]) compared to the meta-analytic benchmark ( g  = 1.51, 95% CI [1.36–1.65]). However, when the results from the CQI process were implemented, treatment effects improved and were found to be non-inferior to the meta-analytic benchmark ( g  = 1.25 to1.27, 95% CI [0.94–1.61]). Conclusions The findings suggest that the integration of measurement-based care, benchmarking, and CQI have the potential to improve treatment outcomes for depression in specialized mental healthcare.