Quality standard
Quality statement 4: Monitoring treatment response
Quality statement 4: Monitoring treatment response
Quality statement
People receiving treatment for an anxiety disorder have their response to treatment recorded at each treatment session.
Rationale
Regular monitoring of psychological and pharmacological treatment response ensures that the effectiveness of treatment can be assessed and treatment adjusted if needed. It also provides an opportunity for healthcare professionals to monitor other outcomes such as effects on any long-term conditions and the person's ability to continue or return to employment.
Quality measures
The following measures can be used to assess the quality of care or service provision specified in the statement. They are examples of how the statement can be measured, and can be adapted and used flexibly.
Structure
Evidence of local arrangements to monitor response to treatment for people being treated for an anxiety disorder at each treatment session and use the findings to adjust delivery of interventions.
Data source: Local data collection.
Process
Proportion of people receiving treatment for an anxiety disorder who have their response to treatment recorded at initial contact and each subsequent treatment session.
Numerator – the number of people in the denominator whose response to treatment is recorded at initial contact and each subsequent treatment session.
Denominator – the number of people receiving treatment for an anxiety disorder.
Data source: Local data collection. Routine outcome monitoring is part of the NHS Digital Improving Access to Psychological Therapies (IAPT) Data Set and the NHS England Children and young people's IAPT programme.
Outcome
Evidence from feedback that people receiving treatment for an anxiety disorder are aware of their progress.
Data source: Local data collection.
What the quality statement means for different audiences
Service providers ensure that systems are in place to record response to treatment at each treatment session for people receiving treatment for anxiety disorders.
Healthcare professionals ensure that they record response to treatment at each treatment session for people receiving treatment for anxiety disorders and adjust treatment if needed.
Commissioners ensure that they commission services that record response to treatment at each treatment session for people receiving treatment for anxiety disorders.
People who are receiving treatment for an anxiety disorder have a check at each treatment session to find out how well their treatment is working and help decide how best to continue with their treatment.
Source guidance
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Post-traumatic stress disorder. NICE clinical knowledge summary (2024), scenario on management
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Post-traumatic stress disorder. NICE guideline NG116 (2018), recommendation 1.2.3
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Social anxiety disorder: recognition, assessment and treatment. NICE guideline CG159 (2013), recommendations 1.3.1 and 1.5.1
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Generalised anxiety disorder and panic disorder in adults: management. NICE guideline CG113 (2011, updated 2020), recommendations 1.2.10, 1.2.16, 1.2.21, 1.3.40, 1.3.44, and 1.3.45
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Obsessive-compulsive disorder and body dysmorphic disorder: treatment. NICE guideline CG31 (2005), recommendation 1.1.2.2 and section 1.2
Definitions
Anxiety disorders
Anxiety disorders are generalised anxiety disorder, social anxiety disorder, post-traumatic stress disorder, panic disorder, obsessive-compulsive disorder and body dysmorphic disorder. [Expert opinion]
Monitoring
This includes individual routine outcome measurement, which can be made available for routine reporting and aggregation of outcome measures, as well as audit and review of effectiveness. Specific monitoring tools and routine outcome measures are used. [Adapted from NICE's guidelines on post-traumatic stress disorder, social anxiety disorder, generalised anxiety disorder and panic disorder in adults, obsessive-compulsive disorder and body dysmorphic disorder and NICE's clinical knowledge summary on post-traumatic stress disorder]
Treatment for an anxiety disorder
Treatments for which responses are monitored include psychological interventions and pharmacological treatment. [Expert opinion]
Equality and diversity considerations
The method of collecting self-reported treatment responses should be tailored to the person with an anxiety disorder, according to their communication needs and preferences. It should be culturally appropriate, accessible to people with additional needs such as physical, sensory or learning disabilities, and to people who do not speak or read English. People with anxiety disorders should have access to an interpreter or advocate if needed.