Niina Markkula1, Ruben Alvarado, Alberto Minoletti. 1. Department of Mental Health and Substance Abuse Services, National Institute for Health and Welfare, Helsinki, Finland. niina.markkula@helsinki.fi
Abstract
OBJECTIVE: Adherence to clinical guidelines for mental disorders among clinicians in industrialized countries is low. Research on guideline adherence among clinicians in lower- and middle-income countries is scarce. The purpose of this study was to evaluate the implementation of clinical guidelines for first-episode schizophrenia in the pilot phase of the Explicit Guarantees in Health (GES) program in Chile. METHODS: Data were collected from 12 catchment areas in Chile, representing 58% of the public health system. Records for 20 patients from each site who were referred to the GES program with a tentative diagnosis of first-episode schizophrenia were reviewed. Adherence to first- and second-line antipsychotic treatments, use of diagnostic measures, and psychosocial interventions recommended in the guidelines were evaluated. RESULTS: In the final sample of 110 patients, adherence to medication guidelines was good-86% received the recommended first-line antipsychotic. Psychoeducation was provided to 55% of patients and 49% of their families, but other psychosocial interventions were used more rarely. Use of symptom rating scales was low. At 12 months, 19% of patients had dropped out of treatment. CONCLUSIONS: Adherence to treatment guidelines in the Chilean GES program was remarkably good for pharmacological treatment, average for psychosocial interventions, and low for utilization of symptom scales and diagnostic measures. The dropout rate was low.
OBJECTIVE: Adherence to clinical guidelines for mental disorders among clinicians in industrialized countries is low. Research on guideline adherence among clinicians in lower- and middle-income countries is scarce. The purpose of this study was to evaluate the implementation of clinical guidelines for first-episode schizophrenia in the pilot phase of the Explicit Guarantees in Health (GES) program in Chile. METHODS: Data were collected from 12 catchment areas in Chile, representing 58% of the public health system. Records for 20 patients from each site who were referred to the GES program with a tentative diagnosis of first-episode schizophrenia were reviewed. Adherence to first- and second-line antipsychotic treatments, use of diagnostic measures, and psychosocial interventions recommended in the guidelines were evaluated. RESULTS: In the final sample of 110 patients, adherence to medication guidelines was good-86% received the recommended first-line antipsychotic. Psychoeducation was provided to 55% of patients and 49% of their families, but other psychosocial interventions were used more rarely. Use of symptom rating scales was low. At 12 months, 19% of patients had dropped out of treatment. CONCLUSIONS: Adherence to treatment guidelines in the Chilean GES program was remarkably good for pharmacological treatment, average for psychosocial interventions, and low for utilization of symptom scales and diagnostic measures. The dropout rate was low.
Authors: Pablo A Gaspar; Rolando I Castillo; Alejandro Maturana; María J Villar; Karen Ulloa; Gabriel González; Osvaldo Ibaceta; Andrea Ortiz; Sebastián Corral; Rocío Mayol; Valeria De Angel; María B Aburto; Antígona Martínez; Cheryl M Corcoran; Hernán Silva Journal: Early Interv Psychiatry Date: 2018-12-11 Impact factor: 2.732
Authors: Franco Mascayano; Ruben Alvarado; Howard F Andrews; Maria Jose Jorquera; Giovanni Marcos Lovisi; Flavia Mitkiewicz de Souza; Charissa Pratt; Graciela Rojas; Maria E Restrepo-Toro; Kim Fader; Prakash Gorroochurn; Sandro Galea; Catarina Magalhães Dahl; Jacqueline Cintra; Sarah Conover; Maria Soledad Burrone; Joy Noel Baumgartner; Robert Rosenheck; Sara Schilling; Keli Rodrigues Sarução; Peter Stastny; Eric Tapia; Maria Tavares Cavalcanti; Eliecer Valencia; Lawrence H Yang; Ezra Susser Journal: Cad Saude Publica Date: 2019-05-02 Impact factor: 1.632
Authors: Edith K Wakida; Celestino Obua; Seggane Musisi; Godfrey Z Rukundo; Peter Ssebutinde; Zohray M Talib; Dickens Akena; Elialilia S Okello Journal: Int J Ment Health Syst Date: 2019-07-17
Authors: Franco Mascayano; Iruma Bello; Howard Andrews; Diego Arancibia; Tamara Arratia; María Soledad Burrone; Sarah Conover; Kim Fader; Maria Jose Jorquera; Mauricio Gomez; Sergio Malverde; Gonzalo Martínez-Alés; Jorge Ramírez; Gabriel Reginatto; Alexandra Restrepo-Henao; Robert A Rosencheck; Sara Schilling; Thomas E Smith; Gonzalo Soto-Brandt; Eric Tapia; Tamara Tapia; Paola Velasco; Melanie M Wall; Lawrence H Yang; Leopoldo J Cabassa; Ezra Susser; Lisa Dixon; Rubén Alvarado Journal: Trials Date: 2022-09-05 Impact factor: 2.728