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1.
Psychiatr Serv ; 72(9): 1012-1017, 2021 09 01.
Artigo em Inglês | MEDLINE | ID: mdl-34018816

RESUMO

OBJECTIVE: The Multilevel Facilitation of Long-Acting Antipsychotic Medication Program (MAP) is a novel intervention to increase the appropriate use of long-acting injectable (LAI) antipsychotics in community mental health clinics. The authors investigated the feasibility of MAP, facilitators and barriers to use, and preliminary impact on LAI medication use. METHODS: Two clinics in Texas and two in Ohio serving 750 and 617 individuals with schizophrenia receiving oral antipsychotics, respectively, were asked to change clinical procedures for 1 year by using either the not receiving optimum benefit (NOB) checklist or the checklist plus MAP. Providers used the NOB checklist to identify individuals who could benefit from switching to LAI antipsychotics. MAP clinics used the NOB checklist plus nonbranded academic detailing for providers and a shared-decision-making video and tool for consumers. Use of MAP components was tracked, and barriers and facilitators were collected quarterly. Antipsychotic prescription counts were provided by participating clinics. RESULTS: Barriers to use of MAP included loss of local champions and administrators, difficulty with provider buy-in, limited availability of peer specialists, and a lack of infrastructural support to integrate MAP into clinic flow. Higher scores on the NOB checklist were associated with more provider LAI medication offers and greater patient acceptance of LAI antipsychotics. LAI medication use increased in clinics over time, but it is unclear whether this increase was due to MAP. CONCLUSIONS: Changing MAP components to fit local procedures and to circumvent unique barriers could aid implementation. Further research should investigate the potential impact of MAP components on LAI medication use.


Assuntos
Antipsicóticos , Esquizofrenia , Antipsicóticos/uso terapêutico , Tomada de Decisão Compartilhada , Preparações de Ação Retardada/uso terapêutico , Humanos , Ohio , Esquizofrenia/tratamento farmacológico
2.
Child Welfare ; 95(5): 79-95, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-30147115

RESUMO

This descriptive study examines the prevalence of comorbid physical and mental health issues among young clients at a large mental health agency. Health status data was collected from the intake process of youth seeking mental health services at a Northeast Ohio agency (n = 1,076). The results show a higher prevalence of asthma and obesity among clients with known mental health diagnoses at this agency compared to national averages. The results could help the agency develop strategies for implementation of an integrated care model to better meet the complex needs of the clients served.

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