Effectiveness of the implementation of guidelines for anxiety disorders in specialized mental health care.

OBJECTIVE

To examine the effect of implementing anxiety disorders guidelines on guideline adherence and patient outcomes in specialized mental health care.

METHOD: A treatment setting in which guidelines were implemented (intervention condition) was compared with one in which guidelines were only disseminated (control condition).

RESULTS

Of 61.7% of 81 intervention-condition patients received treatment according to the guidelines vs. 40.6% of 69 control-condition patients (P = 0.01). At 1-year follow-up, intervention-condition patients showed a greater decrease in anxiety symptoms (d = 0.48, P < 0.05); higher percentages of response (52.6% vs. 33.8%; P = 0.025) and remission (33.3% vs.16.9%; P = 0.026); and a greater decrease in the rate of phobic avoidance (d = 0.34, P < 0.05). At 2-year follow-up, control-condition patients had experienced a longer period of treatment, which had eroded most of these differences, except for phobic avoidance.

CONCLUSION

Systematic guideline implementation results in earlier gains and shorter treatment times.