Treatment‐as‐usual in effectiveness studies: What is it and does it matter?

Andrée Löfholm C, Brännström L, Olsson M, Hansson K. Treatment‐as‐usual in effectiveness studies: What is it and does it matter? A hallmark of an evidence‐based practice (EBP) is the systematic appraisal of research related to the effectiveness of interventions. This study addressed the issue of interpreting results from effectiveness studies that use treatment‐as‐usual (TAU) as a comparator. Using randomised controlled studies that evaluate the effectiveness of multisystemic therapy as an illustrative example, we show that TAU includes a wide variety of treatment alternatives. Estimated treatment effects on recidivism suggest that TAU seems to contain a greater variation in underlying risk than experimental conditions, supporting the hypothesis that the content of TAU could affect outcomes. Implications for the realisation of an EBP are discussed.