Texas Medication Algorithm Project, phase 3 (TMAP-3): clinical results for XXXX with a history of @entity162 .

@entity1 @entity162 @entity308 @entity914 @entity3628 @entity716 @entity2403 @entity34
BACKGROUND: The Texas Medication Algorithm Project (TMAP) assessed the clinical and economic impact of @entity34 ( @entity34 ) as compared with treatment-as-usual (TAU) in @entity1 served in public mental health centers. This report presents clinical outcomes in @entity1 with a history of @entity162 ( @entity2403 ), including @entity162 and @entity914 , @entity162 , during 12 months of treatment beginning March 1998 and ending with the final active @entity1 visit in April 2000. METHOD: @entity1 were diagnosed with @entity162 or @entity914 , @entity162 , according to DSM-IV criteria. @entity34 was comprised of a medication algorithm and manual to guide treatment decisions. Physicians and clinical coordinators received training and expert consultation throughout the project. @entity34 also provided a disorder-specific @entity1 and family education package. TAU clinics had no exposure to the medication algorithms. Quarterly outcome evaluations were obtained by independent raters. @entity3628 , based on a declining effects model, was used to assess clinical outcome of @entity34 versus TAU. RESULTS: @entity34 and TAU @entity1 showed significant initial decreases in symptoms (p =.03 and p <.001, respectively) measured by the 24-item Brief Psychiatric Rating Scale (BPRS-24) at the 3-month assessment interval, with significantly greater effects for the @entity34 group. Limited catch-up by TAU was observed over the remaining 3 quarters. Differences were also observed in measures of @entity162 and @entity716 but not in @entity308 , side-effect burden, or functioning. CONCLUSION: For @entity1 with a history of @entity162 , relative to TAU, the @entity34 intervention package was associated with greater initial and sustained improvement on the primary clinical outcome measure, the BPRS-24, and the secondary outcome measure, the Clinician-Administered Rating Scale for @entity162 (CARS-M). Further research is planned to clarify which elements of the @entity34 package contributed to this between-group difference.
