Asked 21st Jul, 2021
How to assess treatment acceptability in clinical research?
We are currently investigating an integrated treatment module for patients with PTSD and a comorbid eating disorder. Due to the novelty of the treatment, we wish to asses treatment acceptability (TA).
Sekhon et al., (2017) describe TA as ‘a multifaceted construct that reflects the extent to which people delivering or receiving a healthcare intervention consider it to be appropriate, based on anticipated or experienced cognitive and emotional responses to the intervention’. TA appears to change over time, as various authors state that prospective TA, concurrent TA and restrospective TA may differ. Furthermore, clinicians and patients may differ in their perspectives on TA.
Serveral instruments have been developed, such as Treatment Acceptability/Adherence Scale (TAAS) by Milosevic et al., (2015), which measures prospective TA, or the Distress/Endorsement Validation Scale (DEVS, Devilly, 2004). Previous research has also utilized visual analogue scales or costumer satisfaction reports.
For patient TA, i'm thinking about administering the TAAS or DEVS at different time points (before, during or after therapy) to see how TA changes during the course of treatment. An alternitive idea would be to use a randomisation strategy, where each participant would either receive the questionnaire before, during or after treatment. It would be interesting to also assess therapist TA and to see whether or not these match.
Does this seem like a logical set up? Are there any methodological considerations to take into account? All feedback/suggestions are welcome, thanks in advance.
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All Answers (7)
It is a good idea to administer a visual analogue scale before, during and after the therapy. You can expect those with both eating disorder and PTSD not to be too easy to handle and much depends on the chemistry between therapist and client.
It is a good idea to see how well both partners' assessment of TA agrees.
I concur with Beatrice. I have applied the working alliance inventory in case management and court intervention research and found the relationships to be important, but also the reasons for engaging in treatment. The motivation for treatment and expectations regarding treatment are important and persons with eating disorders often lack motivation for change. We have not done a good job in treatment adherence to medication research in measuring whether the person assumes that the intervention will work. Unfortunately, I am not familiar with your measures, but the focus on cognitive and emotional responses are critical and your approach seems logical. You will make an important contribution to the literature by addressing these difficult to treatment groups.
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