Medication Management Decisions in Schizophrenia

精神分裂症的药物管理决策

• 批准号: 6528773
• 负责人: MARK OLFSON
• 金额: $ 49.02万
• 依托单位: COLUMBIA UNIVERSITY HEALTH SCIENCES
• 依托单位国家: 美国
• 财政年份: 2001
• 资助国家: 美国
• 起止时间: 2001-09-01 至 2004-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6528773
• 关键词: antipsychotic agents; behavioral /social science research tag; community mental health services; decision making; health services research tag; human subject; human therapy evaluation; mental disorder chemotherapy; patient oriented research; psychiatric patient care; psychiatrist; schizophrenia; therapy compliance

DESCRIPTION: Antipsychotic medications are highly effective in schizophrenia. Controlled clinical research provides evidence for objective quality standards concerning the selection, dose, duration, and route of administration of antipsychotic medications. Yet, prescribing patterns vary widely, with many patients receiving medication regimens that are inconsistent with these standards. This presumably results in poorer patient outcomes. Surprisingly, very little is known about what has impeded translation of the research findings into clinical practice and why psychiatrists so often prescribe antipsychotic medications in a manner that is not supported by the research literature. This study tests a multidimensional model of medication management decision making. The model incorporates effects of the patient, provider, and treatment environment on the quality of antipsychotic medication management. The overall aim is to identify targets for quality improvement by defining specific critical points in the medication management decision-making process. The main study will have two phases. First, nationally representative survey data will be collected on the knowledge of antipsychotic medications, acceptance of guidelines, clinical confidence, motivation to change practice, and organizational and practice constraints of a randomly selected sample of 1,600 members of the American Psychiatric Association. In the second phase, the psychiatrists will provide information on the medication management and the clinical service and economic characteristics of three randomly selected patients with schizophrenia from their practices. The quality of medication management will be assessed by measuring conformance with treatment recommendations developed by the AHRQ/NIMH Schizophrenia Patient Outcomes Research Team (PORT). Information from both phases of the study will be used to identify specific modifiable patient, psychiatrist, and practice characteristics that promote or impede conformance with the treatment recommendations. The results will inform quality improvement programs by identifying key modifiable determinants of the quality of medication management in the community treatment of schizophrenia.

描述：抗精神病药在精神分裂症中非常有效。 受控临床研究提供了客观质量标准的证据 关于选择，剂量，持续时间和给药途径 抗精神病药。但是，开处方模式差异很大，有许多 接受药物治疗方案的患者与这些药物不一致 标准。据推测，这会导致较差的患者预后。出奇， 关于阻碍研究翻译的内容，知之甚少 临床实践的发现以及为什么经常开精神病医生 抗精神病药以研究不支持的方式 文学。这项研究测试了药物管理的多维模型 决策。该模型结合了患者，提供者和 抗精神病药物管理质量的治疗环境。 总体目的是通过定义来确定质量改进的目标 药物管理决策过程中的特定关键要点。 主要研究将有两个阶段。首先，全国代表调查 数据将收集有关抗精神病药的知识， 接受准则，临床信心，改变实践的动机， 以及随机选择的样本的组织和实践约束 美国精神病学协会的1,600名成员。在第二阶段， 精神科医生将提供有关药物管理和 三个随机选择的临床服务和经济特征 精神分裂症患者的实践。药物的质量 管理将通过衡量与治疗的一致性来评估 AHRQ/NIMH精神分裂症患者结果提出的建议 研究团队（港口）。研究的两个阶段的信息都将用于 确定特定可修改的患者，精神科医生和实践 促进或阻碍符合治疗的特征 建议。结果将为质量改进计划提供信息 识别药物管理质量的关键可修改决定因素 在精神分裂症的社区治疗中。