Routine Outcome Monitoring (ROM) and Feedback: Research Review and Recommendations

ObjectiveTo provide a research review of the components and outcomes of routine outcome monitoring (ROM) and recommendations for research and therapeutic practice.MethodA narrative review of the three phases of ROM - data collection, feeding back data, and adapting therapy - and an overview of patient outcomes from 11 meta-analytic studies.ResultsPatients support ROM when its purpose is clear and integrated within therapy. Greater frequency of data collection is more important for shorter-term therapies, and use of graphs, greater specificity of feedback, and alerts are helpful. Overall effects on patient outcomes are statistically significant (g approximate to 0.15) and increase when clinical support tools (CSTs) are used for not-on-track cases (g approximate to 0.36-0.53). Effects are additive to standard effects of psychological therapies. Organizational, personnel, and resource issues remain the greatest obstacles to the successful adoption of ROM.ConclusionROM offers a low-cost method for enhancing patient outcomes, on average resulting in an approximate to 8% advantage (success rate difference; SRD) over standard care. CSTs are particularly effective for not-on-track patients (SRD between approximate to 20% and 29%), but ROM does not work for all patients and successful implementation is a major challenge, along with securing appropriate cultural adaptations.