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 关于药物的选择、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，有许多 接受与这些不一致的药物治疗方案的患者 标准。这可能会导致患者预后较差。出奇， 对于阻碍研究成果转化的因素知之甚少 临床实践的发现以及为什么精神科医生经常开处方 研究不支持的抗精神病药物治疗方式 文学。这项研究测试了药物管理的多维模型 决策。该模型综合了患者、提供者和患者的影响 治疗环境对抗精神病药物管理质量的影响。 总体目标是通过定义质量改进来确定质量改进目标 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 将收集有关抗精神病药物知识的数据， 对指南的接受、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 1,600 名会员。在第二阶段， 精神科医生将提供有关药物管理和治疗的信息 随机抽取的三名患者的临床服务和经济特征 精神分裂症患者的实践。药品质量 将通过衡量治疗的一致性来评估管理 AHRQ/NIMH 精神分裂症患者结果制定的建议 研究团队（港口）。研究两个阶段的信息将用于 识别特定的可修改患者、精神科医生和实践 促进或阻碍治疗依从性的特征 建议。结果将为质量改进计划提供信息 确定药物管理质量的关键可修改决定因素 精神分裂症的社区治疗。