© 1998 by Oxford University Press and the Maryland Psychiatric Research Center (MPRC)
Patterns of Usual Care for Schizophrenia: Initial Results From the Schizophrenia Patient Outcomes Research Team (PORT) Client Survey
Principal Investigator of the Schizophrenia Patient Outcomes Research Team (PORT), is Professor of Psychiatry, University of Maryland School of Medicine and Co-Director of the Center for Mental Health Services Research, University of Maryland Baltimore, MD
Co-Principal Investigator, is Professor of Health Policy and Management and Chair of the Department of Health Policy and Management, The Johns Hopkins University School of Hygiene and Public Health Baltimore, MD
Reprint requests should be sent to Dr. A.F. Lehman, Dept. of Psychiatry, University of Maryland School of Medicine, 645 West Redwood St., Baltimore, MD 21201
Abstract
To examine the conformance of current patterns of usual care for persons with schizophrenia to the Schizophrenia Patient Outcomes Research Team (PORT) Treatment Recommendations, the PORT surveyed a stratified random sample of 719 persons diagnosed with schizophrenia in two States. The types of treatment settings surveyed included acute inpatient programs and continuing outpatient programs in urban and rural locales. Using data from medical record reviews and patient interviews, the PORT assessed the conformance of current care with 12 of the Treatment Recommendations. The rates at which patients' treatment conformed to the recommendations were modest at best, generally below 50 percent. Conformance rates were higher for pharmacological than for psychosocial treatments and in rural areas than in urban ones. Rates of Treatment Recommendation conformance for minority patients were lower than those for Caucasians, and patterns of care varied between the two States. The findings indicate that current usual treatment practices likely fall substantially short of what would be recommended based on the best evidence on treatment efficacy. This disparity underscores the need for greater efforts to ensure that treatment research results are translated into practice.
Keywords: Mental health services / quality of care
CiteULike 
Connotea 
Del.icio.us What's this?
This article has been cited by other articles:
|
|
 |
|
  T. R. E. Barnes, A. Shingleton-Smith, and C. Paton Antipsychotic long-acting injections: prescribing practice in the UK The British Journal of Psychiatry, November 1, 2009; 195(52): S37 - S42. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. M. Kane and C. Garcia-Ribera Clinical guideline recommendations for antipsychotic long-acting injections The British Journal of Psychiatry, November 1, 2009; 195(52): S63 - S67. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 H. A. Huskamp, J. C. West, D. S. Rae, M. Rubio-Stipec, D. A. Regier, and R. G. Frank Part D and Dually Eligible Patients With Mental Illness: Medication Access Problems and Use of Intensive Services Psychiatr Serv, September 1, 2009; 60(9): 1169 - 1174. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 G. R. Bond, R. E. Drake, G. J. McHugo, C. A. Rapp, and R. Whitley Strategies for Improving Fidelity in the National Evidence-Based Practices Project Research on Social Work Practice, September 1, 2009; 19(5): 569 - 581. [Abstract] [PDF]
|
|
|
|
 |
|
 K. Campbell, G. R. Bond, and R. E. Drake Who Benefits From Supported Employment: A Meta-analytic Study Schizophr Bull, August 6, 2009; (2009) sbp066v1. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
L. I. Sederer Science to Practice: Making What We Know What We Actually Do Schizophr Bull, July 1, 2009; 35(4): 714 - 718. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. E. Drake, G. R. Bond, and S. M. Essock Implementing Evidence-Based Practices for People With Schizophrenia Schizophr Bull, July 1, 2009; 35(4): 704 - 713. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. Mojtabai, L. Fochtmann, S.-W. Chang, R. Kotov, T. J. Craig, and E. Bromet Unmet Need for Mental Health Care in Schizophrenia: An Overview of Literature and New Data From a First-Admission Study Schizophr Bull, July 1, 2009; 35(4): 679 - 695. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. Horvitz-Lennon, J. M. Donohue, M. E. Domino, and S.-L. T. Normand Improving Quality And Diffusing Best Practices: The Case Of Schizophrenia Health Aff., May 1, 2009; 28(3): 701 - 712. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. P. Salyers, J. L. Godfrey, A. B. McGuire, T. Gearhart, A. L. Rollins, and C. Boyle Implementing the Illness Management and Recovery Program for Consumers With Severe Mental Illness Psychiatr Serv, April 1, 2009; 60(4): 483 - 490. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. D. Sherman, E. Fischer, U. B. Bowling, L. Dixon, L. Ridener, and D. Harrison A New Engagement Strategy in a VA-Based Family Psychoeducation Program Psychiatr Serv, February 1, 2009; 60(2): 254 - 257. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. K. Byrne, F. P. Deane, and P. Caputi Mental Health Clinicians' Beliefs About Medicines, Attitudes, and Expectations of Improved Medication Adherence in Patients Eval Health Prof, December 1, 2008; 31(4): 390 - 403. [Abstract] [PDF]
|
|
|
|
|
|
A. S. Young, N. Niv, A. N. Cohen, C. Kessler, and K. McNagny The Appropriateness of Routine Medication Treatment for Schizophrenia Schizophr Bull, November 7, 2008; (2008) sbn138v1. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. J. Mascola Guided Mentorship in Evidence-Based Medicine for Psychiatry: A Pilot Cohort Study Supporting a Promising Method of Real-Time Clinical Instruction Acad Psychiatry, November 1, 2008; 32(6): 475 - 483. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 R. Drake, J. Skinner, and H. H. Goldman What Explains the Diffusion of Treatments for Mental Illness? Am J Psychiatry, November 1, 2008; 165(11): 1385 - 1392. [Full Text] [PDF]
|
|
|
|
|
|
T. Marshall, C. A. Rapp, D. R. Becker, and G. R. Bond Key Factors for Implementing Supported Employment Psychiatr Serv, August 1, 2008; 59(8): 886 - 892. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. L. Drapalski, J. Milford, R. W. Goldberg, C. H. Brown, and L. B. Dixon Perceived Barriers to Medical Care and Mental Health Care Among Veterans With Serious Mental Illness Psychiatr Serv, August 1, 2008; 59(8): 921 - 924. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
P. Bollini, S. Pampallona, S. Nieddu, M. Bianco, G. Tibaldi, and C. Munizza Indicators of Conformance With Guidelines of Schizophrenia Treatment in Mental Health Services Psychiatr Serv, July 1, 2008; 59(7): 782 - 791. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. A. Pickett-Schenk, R. C. Lippincott, C. Bennett, and P. J. Steigman Improving Knowledge About Mental Illness Through Family-Led Education: The Journey of Hope Psychiatr Serv, January 1, 2008; 59(1): 49 - 56. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
I. Hasson-Ohayon, D. Roe, and S. Kravetz A Randomized Controlled Trial of the Effectiveness of the Illness Management and Recovery Program Psychiatr Serv, November 1, 2007; 58(11): 1461 - 1466. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. C. West, J. E. Wilk, I. L. Muszynski, D. S. Rae, M. Rubio-Stipec, C. L. Alter, W. E. Narrow, and D. A. Regier Medication Access and Continuity: The Experiences of Dual-Eligible Psychiatric Patients During the First 4 Months of the Medicare Prescription Drug Benefit Am J Psychiatry, May 1, 2007; 164(5): 789 - 796. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
E. Bromley Barriers to the Appropriate Clinical Use of Medications That Improve the Cognitive Deficits of Schizophrenia Psychiatr Serv, April 1, 2007; 58(4): 475 - 481. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
W. A. Vega, M. Karno, M. Alegria, J. Alvidrez, G. Bernal, M. Escamilla, J. Escobar, P. Guarnaccia, J. Jenkins, A. Kopelowicz, et al. Research Issues for Improving Treatment of U.S. Hispanics With Persistent Mental Disorders Psychiatr Serv, March 1, 2007; 58(3): 385 - 394. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. P. Weiss Measuring the Impact of Medical Research: Moving From Outputs to Outcomes Am J Psychiatry, February 1, 2007; 164(2): 206 - 214. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. A. Cook Employment Barriers for Persons With Psychiatric Disabilities: Update of a Report for the President's Commission Psychiatr Serv, October 1, 2006; 57(10): 1391 - 1405. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
E. S. Casper and C. Carloni Increasing the Utilization of Supported Employment ServicesWith the Need for Change Scale Psychiatr Serv, October 1, 2006; 57(10): 1430 - 1434. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. C. Hermann, J. A. Chan, S. E. Provost, and W. T. Chiu Statistical Benchmarks for Process Measures of Quality of Care for Mental and Substance Use Disorders Psychiatr Serv, October 1, 2006; 57(10): 1461 - 1467. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
K. T. Mueser, P. S. Meyer, D. L. Penn, R. Clancy, D. M. Clancy, and M. P. Salyers The Illness Management and Recovery Program: Rationale, Development, and Preliminary Findings Schizophr Bull, October 1, 2006; 32(suppl_1): S32 - S43. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
G. Borges, M. E. Medina-Mora, P. S. Wang, C. Lara, P. Berglund, and E. Walters Treatment and Adequacy of Treatment of Mental Disorders Among Respondents to the Mexico National Comorbidity Survey Am J Psychiatry, August 1, 2006; 163(8): 1371 - 1378. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. A. Cook, H. S. Leff, C. R. Blyler, P. B. Gold, R. W. Goldberg, R. E. Clark, S. J. Onken, M. S. Shafer, L. E. Blankertz, W. R. McFarlane, et al. Estimated Payments to Employment Service Providers for Persons With Mental Illness in the Ticket to Work Program Psychiatr Serv, April 1, 2006; 57(4): 465 - 471. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. R. Munetz and P. A. Griffin Use of the Sequential Intercept Model as an Approach to Decriminalization of People With Serious Mental Illness Psychiatr Serv, April 1, 2006; 57(4): 544 - 549. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
W. T. CARPENTER Jr. Targeting Schizophrenia Research to Patient Outcomes Am J Psychiatry, March 1, 2006; 163(3): 353 - 355. [Full Text] [PDF]
|
|
|
|
|
|
I. R. H. Falloon, M. Economou, A. Palli, U. Malm, M. Mizuno, M. Murakami, and Optimal Treatment Project Collaborative Group The Clinical Strategies Implementation Scale to Measure Implementation of Treatment in Mental Health Services Psychiatr Serv, December 1, 2005; 56(12): 1584 - 1590. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. D. Sherman, H. D. Faruque, and D. D. Foley Family Participation in the Treatment of Persons With Serious Mental Illness Psychiatr Serv, December 1, 2005; 56(12): 1624 - 1625. [Full Text]
|
|
|
|
 |
|
 S. Marwaha and S. Johnson Views and Experiences of Employment among People with Psychosis: A Qualitative Descriptive Study International Journal of Social Psychiatry, December 1, 2005; 51(4): 302 - 316. [Abstract] [PDF]
|
|
|
|
 |
|
 J. LeGris Parents of young people with mental health problems experienced a deskilling and had to learn to reskill themselves Evid. Based Nurs., October 1, 2005; 8(4): 125 - 125. [Full Text] [PDF]
|
|
|
|
|
|
P. C. Brown and W. M. Tucker Overstating the Case About Recovery? Psychiatr Serv, August 1, 2005; 56(8): 1022 - 1023. [Full Text]
|
|
|
|
|
|
D. J. Luchins, I. Chiriac, P. Hanrahan, M. Goldman, R. Fabian, and G. Tolley Economic Grand Rounds: Allocating Funds for Medications and Psychosocial Interventions: How Consumers Would Divide the Pie Psychiatr Serv, July 1, 2005; 56(7): 799 - 801. [Full Text] [PDF]
|
|
|
|
|
|
J. C. West, J. E. Wilk, M. Olfson, D. S. Rae, S. Marcus, W. E. Narrow, H. A. Pincus, and D. A. Regier Patterns and Quality of Treatment for Patients With Schizophrenia in Routine Psychiatric Practice Psychiatr Serv, March 1, 2005; 56(3): 283 - 291. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. P. Liberman and I. D. Glick Rehab Rounds: Drug and Psychosocial Curricula for Psychiatry Residents for Treatment of Schizophrenia: Part I Psychiatr Serv, November 1, 2004; 55(11): 1217 - 1219. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
L. Dixon The Need for Implementing Evidence-Based Practices Psychiatr Serv, October 1, 2004; 55(10): 1160 - 1161. [Full Text] [PDF]
|
|
|
|
|
|
D. M. Herbeck, J. C. West, I. Ruditis, F. F. Duffy, D. J. Fitek, C. C. Bell, and L. R. Snowden Variations in Use of Second-Generation Antipsychotic Medication by Race Among Adult Psychiatric Patients Psychiatr Serv, June 1, 2004; 55(6): 677 - 684. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. G. Resnick, R. A. Rosenheck, and A. F. Lehman An Exploratory Analysis of Correlates of Recovery Psychiatr Serv, May 1, 2004; 55(5): 540 - 547. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
E. A. Latimer, P. W. Bush, D. R. Becker, R. E. Drake, and G. R. Bond The Cost of High-Fidelity Supported Employment Programs for People With Severe Mental Illness Psychiatr Serv, April 1, 2004; 55(4): 401 - 406. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
T. Marshall and P. Solomon Professionals' Responsibilities in Releasing Information to Families of Adults With Mental Illness Psychiatr Serv, December 1, 2003; 54(12): 1622 - 1628. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
N. Sohler, M. Olfson, and J. Walkup Dosages and Outcomes Psychiatr Serv, November 1, 2003; 54(11): 1547 - 1548. [Full Text] [PDF]
|
|
|
|
|
|
R. WARNER How much of the burden of schizophrenia is alleviated by treatment? The British Journal of Psychiatry, November 1, 2003; 183(5): 375 - 376. [Full Text] [PDF]
|
|
|
|
|
|
D. Mechanic Policy Challenges in Improving Mental Health Services: Some Lessons From the Past Psychiatr Serv, September 1, 2003; 54(9): 1227 - 1232. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
N. L. Sohler, J. Walkup, D. McAlpine, C. Boyer, and M. Olfson Antipsychotic Dosage at Hospital Discharge and Outcomes Among Persons With Schizophrenia Psychiatr Serv, September 1, 2003; 54(9): 1258 - 1263. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 R. R. Owen, E. P. Fischer, J. E. Kirchner, C. R. Thrush, D. K. Williams, B. J. Cuffel, C. E. Elliott, and B. M. Booth Clinical Practice Variations in Prescribing Antipsychotics for Patients With Schizophrenia American Journal of Medical Quality, July 1, 2003; 18(4): 140 - 146. [Abstract] [PDF]
|
|
|
|
|
|
P. W. Corrigan and A. C. Watson Factors That Explain How Policy Makers Distribute Resources to Mental Health Services Psychiatr Serv, April 1, 2003; 54(4): 501 - 507. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. D. Sherman Rehab Rounds: The Support and Family Education (SAFE) Program: Mental Health Facts for Families Psychiatr Serv, January 1, 2003; 54(1): 35 - 37. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. Tapp, A. E. Wood, L. Secrest, J. Erdmann, L. Cubberley, and N. Kilzieh Combination Antipsychotic Therapy in Clinical Practice Psychiatr Serv, January 1, 2003; 54(1): 55 - 59. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. R. Owen, D. Cannon, and C. R. Thrush Mental Health QUERI Initiative: Expert Ratings of Criteria to Assess Performance for Major Depressive Disorder and Schizophrenia American Journal of Medical Quality, January 1, 2003; 18(1): 15 - 20. [Abstract] [PDF]
|
|
|
|
|
|
T. BURNS, J. CATTY, H. WATT, C. WRIGHT, M. KNAPP, and J. HENDERSON International differences in home treatment for mental health problems: Results of a systematic review The British Journal of Psychiatry, November 1, 2002; 181(5): 375 - 382. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. CHILVERS, G. HARRISON, A. SIPOS, and M. BARLEY Evidence into practice: Application of psychological models of change in evidence-based implementation The British Journal of Psychiatry, August 1, 2002; 181(2): 99 - 101. [Full Text] [PDF]
|
|
|
|
 |
|
 J. A. Cook and J. A. Jonikas Self-Determination Among Mental Health Consumers/Survivors: Using Lessons From the Past to Guide the Future Journal of Disability Policy Studies, January 1, 2002; 13(2): 88 - 96. [Abstract] [PDF]
|
|
|
|
 |
|
 I. D. Glick, T. Suppes, C. DeBattista, R. J. Hu, and S. Marder Psychopharmacologic Treatment Strategies for Depression, Bipolar Disorder, and Schizophrenia Ann Intern Med, January 2, 2001; 134(1): 47 - 60. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
G. R. Bond, R. E. Drake, D. R. Becker, and K. T. Mueser Effectiveness of Psychiatric Rehabilitation Approaches for Employment of People with Severe Mental Illness Journal of Disability Policy Studies, January 1, 1999; 10(1): 18 - 52. [Abstract] [PDF]
|
|