Assessing Conformance to Medication Treatment Guidelines for Schizophrenia in a Community Mental Health Center (CMHC)

Concordia University–Ann Arbor, Ann Arbor, Michigan, United States
Community Mental Health Journal (Impact Factor: 1.03). 01/2004; 39(6):549-55. DOI: 10.1023/B:COMH.0000003015.68850.f2
Source: PubMed


The feasibility of implementing current medication treatment guidelines in a community mental health clinic was examined in this cross-sectional and retrospective study. Specifically, two issues were addressed: 1) could we identify a set of clinical guidelines whose utilization could be monitored with a routine medical chart review; and 2) were the requisite data for such a review available in the medical records. An examination of three sets of published guidelines revealed 5 specific guidelines that could be operationalized and monitored. Records were reviewed for a random sample of two-thirds of all patients currently diagnosed with schizophrenia and schizoaffective disorder (n = 309). Information was collected from the medical record on patient demographics, diagnosis, duration of illness, symptoms and side effects, and medication information. Rates of conformance to the 5 guidelines ranged from a high of 97% to a low of 43%. The use of current guidelines to improve treatment in community clinics appears to be limited by the deficiencies in the medical record and the structure of the guidelines themselves. Standardized progress notes and computerized prescribing programs will improve conformance, and permit the rapid and accurate assessment of conformance to guidelines in community clinics.

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Available from: Karen K Milner, Oct 29, 2015
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    • "'Incorporation' is the key concept in the preceding passages. Well-intentioned efforts that equate conformance to a guideline with its utilization in practice have tended to exacerbate the very resistance that EBM was seeking to overcome [31]. Battle lines are drawn when clinicians are told, in one way or another, that the quality of their work can be gauged by how closely they conform to guidelines that were developed for the express purpose of aiding their decisions rather than directing them [32,33]. "
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