Patterns and Quality of Treatment for Patients With Schizophrenia in Routine Psychiatric Practice

Abstract

These data suggest unmet need for psychosocial treatment services among individuals with schizophrenia. These findings raise questions about whether currently available antipsychotic medications are being used optimally or whether they offer limited effectiveness for patients with complex clinical problems who are treated in routine psychiatric practice.

Barriers to Evidence-Based Practice Implementation: Results of a Qualitative Study

“…They found, for example, that only 22% of consumers in outpatient programs received any vocational services. A recent study found that of unemployed patients, none received any form of vocational rehabilitation (West et al 2005). The situation is parallel with other evidencebased practices: medication service, family psychoeducation, integrated dual diagnosis treatment, etc.…”

Structural and Organizational Determinants of Quality of Care in Patients With Schizophrenia in Italy

“…The results indicated a dramatic difference between the 2 systems, one using higher doses of medication in association with having fewer staff and less treatment time for patients and families. Pharmacological treatment nonconformant to guideline recommendations is often attributed to insufficient knowledge or experience of the prescribing psychiatrist concerning latest research findings, or to the complexity of patients seen in routine clinical practice (Dickey et al, 2006;West et al, 2005): research often conceives prescribing drugs as an activity performed in isolation, as the responsibility of a single doctor, only governed by the doctorpatient relationship. Instead, it is an act occurring in a complex institutional environment (Greenberg et al, 2006).…”

Determinants of Health Plan Membership Among Patients in Routine U.S. Psychiatric Practice

“…For those patients with schizophrenia/other psychotic disorders who do belong to a health plan, the plan is usually a public-sector health plan (e.g., Medicare and Medicaid). Prior research from the PRN has shown that for patients with psychotic disorders receiving treatment from a psychiatrist through a publicly insured plan, access to second generation antipsychotics and psychosocial treatment is particularly limited (Herbeck et al, 2004;West et al, 2005). Reimbursement levels in public-sector plans may also serve as a barrier to access to treatments.…”