Medication Management Decisions in Schizophrenia

抗精神病药物对精神分裂症非常有效。 对照临床研究为客观质量标准提供了证据 关于选择、剂量、持续时间和给药途径， 抗精神病药物然而，处方模式差异很大， 接受与这些方案不一致的药物治疗方案的患者 标准这可能导致患者结局较差。令人惊奇的是， 关于是什么阻碍了这项研究的翻译，人们知之甚少。 以及为什么精神科医生经常开 抗精神病药物的方式是不支持的研究 文学本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 治疗环境对抗精神病药物管理质量的影响。 总的目标是通过确定质量改进的目标， 药物管理决策过程中的具体关键点。 主要研究将分为两个阶段。一、全国代表性调查 将收集关于抗精神病药物知识的数据， 接受指南，临床信心，改变实践的动机， 和组织和实践的限制，随机选择的样本， 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 临床服务和经济特征的三个随机选择 精神分裂症患者的治疗方法药物的质量 将通过测量治疗依从性来评估管理 由AHRQ/NIMH精神分裂症患者结局制定的建议 研究小组（港口）。研究两个阶段的信息将用于 确定特定可修改患者、精神病医生和实践 促进或阻碍治疗依从性的特征 建议.结果将通过以下方式为质量改进计划提供信息： 确定药物管理质量的关键可变决定因素 精神分裂症的社区治疗

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.