Organizational Fidelity to a Medication Management Evidence-Based Practice in the Treatment of Schizophrenia

El-Mallakh, Peggy; Howard, Patricia Kunz; Rayens, Mary Kay; Roque, Autumn; Adkins, Sarah

doi:10.3928/02793695-20130809-01

Cited by 3 publications

(2 citation statements)

References 37 publications

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“…Of the 61 articles included in the analysis, 43 [ 39 – 81 ] were research articles and 18 [ 82 – 99 ] were non-research articles (e.g., practice articles, policy updates, issue pieces, case studies, and commentaries). Additionally, 48 articles [ 39 – 41 , 43 , 44 , 48 – 53 , 55 , 57 – 68 , 71 – 80 , 82 , 83 , 86 – 93 , 96 – 99 ] discussed a single intervention; 6 [ 47 , 54 , 81 , 84 , 85 , 94 ] discussed multiple interventions related to the same health problem; and 7 [ 42 , 45 , 46 , 56 , 69 , 70 , 95 ] discussed issues related to the implementation of interventions associated with a specific health problem more generally. Regarding the issues interventions sought to address: 27 [ 42 – 44 , 47 – 50 , 52 , 54 , 55 , 58 – 61 , 63 , 68 , 69 , 73 , 82 , 86 , 87 , 91 , 93 – 95 , 97 ] discussed behavioral health, mental health, or substance use interventions; 16 [ 45 , 51 , 56 , 57 , 62 , 64 , 67 , 72 , 76 , 79 , …”

Section: Resultsmentioning

confidence: 99%

Defining the external implementation context: an integrative systematic literature review

Watson

Adams

Shue

et al. 2018

BMC Health Serv Res

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BackgroundProper implementation of evidence-based interventions is necessary for their full impact to be realized. However, the majority of research to date has overlooked facilitators and barriers existing outside the boundaries of the implementing organization(s). Better understanding and measurement of the external implementation context would be particularly beneficial in light of complex health interventions that extend into and interact with the larger environment they are embedded within. We conducted a integrative systematic literature review to identify external context constructs likely to impact implementation of complex evidence-based interventions.MethodsThe review process was iterative due to our goal to inductively develop the identified constructs. Data collection occurred in four primary stages: (1) an initial set of key literature across disciplines was identified and used to inform (2) journal and (3) author searches that, in turn, informed the design of the final (4) database search. Additionally, (5) we conducted citation searches of relevant literature reviews identified in each stage. We carried out an inductive thematic content analysis with the goal of developing homogenous, well-defined, and mutually exclusive categories.ResultsWe identified eight external context constructs: (1) professional influences, (2) political support, (3) social climate, (4) local infrastructure, (5) policy and legal climate, (6) relational climate, (7) target population, and (8) funding and economic climate.ConclusionsThis is the first study to our knowledge to use a systematic review process to identify empirically observed external context factors documented to impact implementation. Comparison with four widely-utilized implementation frameworks supports the exhaustiveness of our review process. Future work should focus on the development of more stringent operationalization and measurement of these external constructs.Electronic supplementary materialThe online version of this article (10.1186/s12913-018-3046-5) contains supplementary material, which is available to authorized users.

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Section: Resultsmentioning

confidence: 99%

Defining the external implementation context: an integrative systematic literature review

Watson

Adams

Shue

et al. 2018

BMC Health Serv Res

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“…In Table 1, longitudinal intervention studies (n ¼ 8) with duration of at least 2 years are presented in detail. We identified three main aims related to medication management intervention: medication quality (El-Mallakh et al, 2013;Howard et al, 2009;Maples et al, 2012), dose tapering (Bergstrom et al, 2018;Calton et al, 2008;Isohanni 1983Isohanni , 1993Lehtinen et al, 2000), and adherence (Pitschel-Walz et al, 2006;Morken, Grawe, & Widen, 2007). There were a number of positive outcomes, but findings were overall mixed.…”

Section: Longitudinal (Over 2 Years Of Follow-up or Study Period) Cmentioning

confidence: 99%

Medication management of antipsychotic treatment in schizophrenia—A narrative review

Isohanni

Jääskeläinen

Miller

et al. 2020

Human Psychopharmacology

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Background/Objective: The risk-benefit ratio of antipsychotics in schizophrenia depends primarily on their effect on brain chemistry. An important factor influencing the efficacy of prescribed drugs is medication management, which can be defined as an ongoing process to manage and monitor the recommended use of antipsychotics to facilitate their cost-effective, adherent, and acceptable use. Materials: We reviewed narratively relevant literature that examined the medication management of antipsychotics in schizophrenia based on a search of PubMed, Scopus, Web of Science, PsycARTICLES, and Cochrane in May 2020. We also included controlled interventional studies with a follow-up period of at least 2 years. Result: Based on the previous literature, there is no unified approach for optimal medication management, but multiple useful strategies are presented for individual patients, prescribers, and organizations. Conclusions: Systematic medication management may improve the risk-benefit balance of antipsychotics by achieving the lowest effective dose, minimizing adverse effects, and improving adherence. There is a need for well-designed naturalistic studies and clinical trials to optimize management in schizophrenia.

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Organizational Fidelity to a Medication Management Evidence-Based Practice in the Treatment of Schizophrenia

El-Mallakh¹,

Howard²,

Rayens³

et al. 2013

J Psychosoc Nurs Ment Health Serv

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Organizational support is essential for successful implementation of evidence-based practice (EBP) in clinical settings. This 3-year study used a mixed qualitative and quantitative design to implement a medication management EBP in the treatment of schizophrenia in six community mental health clinics in a south-central state of the United States. Findings from organizational fidelity assessments indicate that support for EBP implementation was moderate. Organizational support was highest for prescriber access to relevant patient information at each medication visit, scheduling flexibility for patients' urgent problems, and availability of medication guidelines. Organizational support was lowest for medication availability and identification of treatment refractory patients. Findings suggest that leadership is essential to support successful implementation. Nurse educators can incorporate implementation research and leadership training into graduate nursing programs to facilitate successful EBP implementation in practice settings.

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Organizational Fidelity to a Medication Management Evidence-Based Practice in the Treatment of Schizophrenia

Cited by 3 publications

References 37 publications

Defining the external implementation context: an integrative systematic literature review

Defining the external implementation context: an integrative systematic literature review

Medication management of antipsychotic treatment in schizophrenia—A narrative review

Organizational Fidelity to a Medication Management Evidence-Based Practice in the Treatment of Schizophrenia

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