Implementing Patient-Reported Outcomes to Improve the Quality of Care for Weight of Patients with Schizophrenia

  • Alexander S. YoungEmail author
  • Amy N. Cohen
  • Alison B. Hamilton
  • Gerhard Hellemann
  • Christopher Reist
  • Fiona Whelan


“Enhancing QUality of Care In Psychosis” (EQUIP) was an eight-site clustered controlled trial of the implementation and effectiveness of patient-reported outcomes to support evidence-based practice and improve care for schizophrenia. Implementation sites chose to improve care for weight. Implementation included monitoring patient-reported outcomes using kiosks, patient and staff education, quality improvement teams, and phone care management. Qualitative and quantitative methods compared implementation and effectiveness between sites for 13 months. Eighty percent of 801 randomly selected patients were overweight. Two hundred one clinicians varied in competency. Baseline use of behavioral weight services was low. At implementation sites, patients became 2.3 times more likely to use weight services compared with control sites (95% CI, 1.5–3.6; χ2 = 14.4; p < 0.01). There was no effect on the weight gain liability of medications prescribed. Controlling for baseline, patients’ final weight at control sites was 5.9 ± 2.7 kg heavier than at implementation sites (F = 4.8, p = 0.03). Patient-reported outcomes can inform implementation of evidence-based practice and improvement in outcomes.



This research was supported by the Department of Veterans Affairs, Veterans Health Administration, Health Services Research and Development Service Quality Enhancement Research Initiative (MNT 03-213), and VISN 22 Mental Illness Research, Education, and Clinical Center (MIRECC). Views expressed in this article are those of the authors and do not necessarily represent the views of any affiliated institutions. The authors would like to thank the investigators, staff, and clinicians of the EQUIP project at the Department of Veterans Affairs Healthcare Centers at Bronx, NY; Houston, TX; Long Beach, CA; Los Angeles, CA; Northport, NY; Shreveport, LA; Temple, TX; and Waco, TX.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflicts of interest.


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Copyright information

© This is a U.S. government work and its text is not subject to copyright protection in the United States; however, its text may be subject to foreign copyright protection  2018

Authors and Affiliations

  1. 1.Greater Los Angeles Veterans Healthcare CenterLos AngelesUSA
  2. 2.University of CaliforniaLos AngelesUSA
  3. 3.UCLA Center for Health ServicesLos AngelesUSA
  4. 4.Veterans Health Administration, MIRECCLos AngelesUSA
  5. 5.Long Beach Veterans Healthcare SystemLong BeachUSA
  6. 6.University of CaliforniaIrvineUSA

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