Reduction of Concurrent Antipsychotic Prescribing Practices Through the Use of PSYCKES
Rent the article at a discountRent now
* Final gross prices may vary according to local VAT.Get Access
The New York State Office of Mental Health has implemented the browser based Psychiatric Clinical Knowledge Enhancement System (PSYCKES) medication application throughout its inpatient system of care. PSYCKES provides detailed current medication regimens and histories, as well as medication best practices reports at the patient, psychiatrist, ward, and facility levels. South Beach Psychiatric Center (SBPC) has made specific use of a best practices report which details proportions of caseloads and number of patients on two or more concurrent antipsychotic medications. Psychiatrists received extensive application and desktop support and individual and group training was conducted. PSYCKES current and historical medication regimens were reviewed for individual cases and best practices reports were used in psychiatry supervision from January 2004 to March 2005. SBPC psychiatrists achieved marked reductions in the proportions of their caseloads on two or more concurrent antipsychotics. Although we cannot impute causality from this pre–post implementation design, the results of this evaluation suggest that the use of PSYCKES was effective in reducing such regimens for inpatients.
- American Psychiatric Association (2004). Practice guideline for the treatment of patients with schizophrenia. American Journal of Psychiatry, 161(Suppl. Feb), 1–114.
- Bauer, M. S. (2002). A review of quantitative studies of adherence to mental health clinical practice guidelines. Harvard Review of Psychiatry, 10(3), 138–153. CrossRef
- Clark, R. E., Bartels, S. J., Mellman, T. A., & Peacock, W. J. (2002). Recent trends in antipsychotic combination therapy of schizophrenia and schizoaffective disorder: Implications for state mental health policy. Schizophrenia Bulletin, 28(1), 75–84.
- Cohen, T., Kaufman, D., White, T., Segal, G., Bennett-Staub, A., Patel, V., & Finnerty, M. (2004) Cognitive evaluation of an innovative psychiatric clinical knowledge enhancement system. Medinfo, 11, 1295–1299.
- Expert Consensus Guildelines Series (1999). Treatment of schizophrenia 1999. Journal of Clinical Psychiatry, 60(Suppl. 11), 3–80.
- Finnerty, M., Altmansberger, R., Bopp, J., Carpinello, S., Docherty, J. P., Fisher, W., Jensen, P., Krishnan, P., Mittleman, M., Olfson, M., Tricarico, J., White, T., & Felton, C. (2002). Using state administrative and pharmacy data bases to develop a clinical decision support tool for schizophrenia guidelines. Schizophrenia Bulletin, 28, 85–94.
- Freudenreich, O., & Goff, D. C. (2002). Antipsychotic combination therapy in schizophrenia. A review of efficacy and risks of current combinations. Acta Psychiatrica Scandinavia, 106, 323–330. CrossRef
- Ganguly, R., Kotzan, J. A., Miller, L. S., Kennedy, K., & Martin, B. C. (2004). Prevalence, trends, and factors associated with antipsychotic polypharmacy among Medicaid-eligible schizophrenia patients. 1998–2000. Journal of Clinical Psychiatry, 65(10), 1377–1388. CrossRef
- Gray, J. (2006). Changing physician prescribing behavior. Canadian Journal of Clinical Pharmacology, 13(1), e81-e84.
- Lerner, V., Libov, I., Kotler, M., & Strous, R. D. (2004). Combination of “atypical” antipsychotic medication in the management of treatment-resistant schizophrenia and schizoaffective disorder. Progress in Neuro-Psychopharmacology and Biological Psychiatry, 28, 89–98. CrossRef
- Lin, E. H. B., Kayton, W. J., Simon, G. E., Von Korff, M., Bush, T. M., Rutter, C. M., Saunders, K. W., & Walker, A. (1997). Achieving guidelines for treatment of depression in primary care: Is physician education enough? Medical Care, 35(8), 831–842. CrossRef
- Love, R. C., Mackowick, M., Carpenter, D., & Burks, E. J. (2003). Expert consensus-based medication use evaluation criteria for atypical antipsychotic drugs. American Journal of Health System Pharmacy, 60(Dec), 2455–2470.
- Miller, A. L., Chiles, J. A., Chiles, J. K., Crimson, M. L., Rush, A. J., & Shon, S. P. (1999). The Texas Medication Algorithm Project (TMAP) schizophrenia algorithms. Journal of Clinical Psychiatry, 60, 649–657.
- New York State Office of Mental Health (2003). Recommendations for the pharmacological management of schizophrenia. Albany, NY: NYS-OMH.
- Schroeder, N. H., Caffey, E. M., & Lorei, T. W. (1979). Antipsychotic drug: Can education change prescribing practices. Journal of Clinical Psychiatry, 40, 186–189.
- Statistical Analysis Systems, Inc. (2003). SAS Version 9.1.2. Cary, NC: Author.
- Yuzda, M. S. K. (2000). Combination antipsychotics: What is the evidence? Journal of Informed Pharmacotherapy, 2, 300–305.
- Reduction of Concurrent Antipsychotic Prescribing Practices Through the Use of PSYCKES
Administration and Policy in Mental Health and Mental Health Services Research
Volume 34, Issue 1 , pp 57-61
- Cover Date
- Print ISSN
- Online ISSN
- Springer US
- Additional Links
- Best practices
- Concurrent medications
- Clinical decision support
- Clinical information systems