Ignite Creation Date:
2024-05-05 @ 11:52 AM
Last Modification Date:
2024-10-26 @ 9:15 AM
Study NCT ID:
NCT00156637
Status:
COMPLETED
Last Update Posted:
2015-04-07
First Post:
2005-09-07
Brief Title:
A Study of Strategies to Improve Schizophrenia Treatment
Sponsor:
US Department of Veterans Affairs
Organization:
VA Office of Research and Development
Study Overview
Official Title:
A Study of Strategies to Improve Schizophrenia Treatment
Status:
COMPLETED
Status Verified Date:
2008-04
Last Known Status:
None
Delayed Posting:
No
If Stopped, Why?:
Not Stopped
Has Expanded Access:
False
If Expanded Access, NCT#:
N/A
Has Expanded Access, NCT# Status:
N/A
Acronym:
None
Brief Summary:
The goal of this project is to translate research findings about key aspects of antipsychotic treatment into routine care through a multi-component intervention focusing on improving two aspects of medication management that are directly linked to patient outcomes 1 monitoring for potentially serious metabolic side effects of newer antipsychotic medication and 2 increasing the appropriate use of clozapine for treatment-refractory patients
Detailed Description:
Background
Antipsychotic medication is by far the most widely utilized treatment for schizophrenia in VA settings and the VA has established guidelines for the appropriate use of these medications The recent introduction of a new generation of antipsychotic medications has also offered great hope to persons with schizophrenia but also may adversely affect health due to metabolic side effects Improving all aspects of antipsychotic medication management is necessary to improve outcomes for persons with schizophrenia
Objectives
The goal of this project is to translate research findings about key aspects of antipsychotic treatment into routine care through a multi-component intervention Mental Health QUERIs MHQ previous project for improving antipsychotic treatment demonstrated that a multi-component intervention improved use of guideline-recommended antipsychotic doses This project will build on results and lessons learned from MHQs previous translation project The scope of translation will be expanded from an ongoing focus on reducing high antipsychotic doses to include two additional aspects of medication management that are directly linked to patient outcomes 1 increasing monitoring for potentially serious side effects of newer antipsychotic medication and 2 increasing the appropriate use of clozapine for treatment-refractory patients
Methods
The project is employing a multi-component intervention for improving antipsychotic prescribing while comparing the use of two different interpersonal marketinginfluence strategies for translation The primary objective is to compare the effectiveness of a team-based QI approach and a strategy using a clinical opinion leader augmented by an implementation coordinator to improve antipsychotic medication management In addition MHQ will determine the impact of a support and consultation program to promote clozapine prescribing A total of ten VA Medical Centers from 4 different VA health care networks VISNs have been selected to participate on the basis of number of patients with schizophrenia baseline performance on quality indicators and organizational characteristics Six of these sites will focus on side effect monitoring and antipsychotic dosing two team-based QI two clinical opinion leader and two control while two will receive the clozapine consultation program with two matched control sites Selected clinicians and staff opinion leaders will be identified and trained and will implement the multi-component intervention consisting of educational materials and programs information system tools and performance monitoring and feedback The intervention will take place for 6 months and will be assessed with regard to improvement in side effect monitoring high dose antipsychotic prescribing and clozapine use In addition MHQ will assess impact of the intervention on patient outcomes at five of the sites
Status
In partnership with clinical stakeholders the project team is implementing adapting and evaluating an assortment of clinical tools and training materials designed to improve antipsychotic medication management All sites except 1 have completed the intervention All subject recruitment had been completed The project team is also working with participating VAMC IT staff and Clinical Coordinators to fully automate the projects VISTA data extraction reoutines and performance monitoring reporting system for local implmentation and maintainence
Antipsychotic medication is by far the most widely utilized treatment for schizophrenia in VA settings and the VA has established guidelines for the appropriate use of these medications The recent introduction of a new generation of antipsychotic medications has also offered great hope to persons with schizophrenia but also may adversely affect health due to metabolic side effects Improving all aspects of antipsychotic medication management is necessary to improve outcomes for persons with schizophrenia
Objectives
The goal of this project is to translate research findings about key aspects of antipsychotic treatment into routine care through a multi-component intervention Mental Health QUERIs MHQ previous project for improving antipsychotic treatment demonstrated that a multi-component intervention improved use of guideline-recommended antipsychotic doses This project will build on results and lessons learned from MHQs previous translation project The scope of translation will be expanded from an ongoing focus on reducing high antipsychotic doses to include two additional aspects of medication management that are directly linked to patient outcomes 1 increasing monitoring for potentially serious side effects of newer antipsychotic medication and 2 increasing the appropriate use of clozapine for treatment-refractory patients
Methods
The project is employing a multi-component intervention for improving antipsychotic prescribing while comparing the use of two different interpersonal marketinginfluence strategies for translation The primary objective is to compare the effectiveness of a team-based QI approach and a strategy using a clinical opinion leader augmented by an implementation coordinator to improve antipsychotic medication management In addition MHQ will determine the impact of a support and consultation program to promote clozapine prescribing A total of ten VA Medical Centers from 4 different VA health care networks VISNs have been selected to participate on the basis of number of patients with schizophrenia baseline performance on quality indicators and organizational characteristics Six of these sites will focus on side effect monitoring and antipsychotic dosing two team-based QI two clinical opinion leader and two control while two will receive the clozapine consultation program with two matched control sites Selected clinicians and staff opinion leaders will be identified and trained and will implement the multi-component intervention consisting of educational materials and programs information system tools and performance monitoring and feedback The intervention will take place for 6 months and will be assessed with regard to improvement in side effect monitoring high dose antipsychotic prescribing and clozapine use In addition MHQ will assess impact of the intervention on patient outcomes at five of the sites
Status
In partnership with clinical stakeholders the project team is implementing adapting and evaluating an assortment of clinical tools and training materials designed to improve antipsychotic medication management All sites except 1 have completed the intervention All subject recruitment had been completed The project team is also working with participating VAMC IT staff and Clinical Coordinators to fully automate the projects VISTA data extraction reoutines and performance monitoring reporting system for local implmentation and maintainence
Study Oversight
Has Oversight DMC:
None
Is a FDA Regulated Drug?:
None
Is a FDA Regulated Device?:
None
Is an Unapproved Device?:
None
Is a PPSD?:
None
Is a US Export?:
None
Is an FDA AA801 Violation?:
None