Abstract
Objective
Facility in psychopharmacology is a major goal of psychiatric residency. This study assesses the adequacy of pharmacotherapy provided to depressed patients in a resident clinic.
Methods
Charts of all 285 patients seen in an outpatient triage clinic during 2000 were reviewed. One hundred twelve patients had diagnoses of major depression, dysthymia, depressive disorder not otherwise specified, adjustment disorder with depressed mood, or bipolar disorder with a documented depressed episode during the studied period. Pharmacotherapy prescribed to these 112 patients was rated using the Antidepressant Treatment History Form (ATHF). Also analyzed were weeks in treatment and Clinical Global Impression (CGI) Severity score assigned retrospectively.
Results
Of the 112 charts subjected to detailed review, 49.1% documented adequate treatment. Antidepressant Treatment History Form ratings increased with treatment duration. No correlation was found between ATHF ratings and CGI ratings.
Conclusions
Results suggest that time retained in treatment is a major factor in treatment adequacy.
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References
ACGME Outcome Project: Enhancing residency education through outcomes assessment. http://www.acgme.org/outcome/
Hirschfeld RM, Keller MB, Panico S, et al: The national depressive and manic-depressive association consensus statement on the undertreatment of depression. JAMA 1997; 277: 333–340
Sackeim HA: The definition and meaning of treatment-resistant depression. J Clin Psychiatry 2001; 62(suppl 16): 10–17
Sirey JA, Meyers BS, Bruce ML, et al: Predictors of antidepressant prescription and early use among depressed outpatients. Am J Psychiatry 1999; 156: 690–696
Mulsant BH, Haskett RF, Prudic J, et al: Low use of neuroleptic drugs in the treatment of psychotic major depression. Am J Psychiatry 1997; 154: 559–561
McCall WV, Reboussin BA, Cohen W, et al: Electroconvulsive therapy is associated with superior symptomatic and functional change in depressed patients after psychiatric hospitalization. J Affect Disord 2001; 63: 17–25
Oquendo MA, Baca-Garcia E, Kartachov A, et al: A computer algorithm for calculating the adequacy of antidepressant treatment in unipolar and bipolar depression. J Clin Psychiatry 2003; 64: 825–833
Shasha M, Lyons JS, O’Mahoney MT, et al: Serotonin reuptake inhibitors and the adequacy of antidepressant treatment. Int J Psychiatry Med 1997; 27: 83–92
Ramana R, Paykel ES, Surtees PG, et al: Medication received by patients with depression following the acute episode: adequacy and relation to outcome. Br J Psychiatry 1999; 174: 128–134
Katon W, von Korff M, Lin E, et al: Adequacy and duration of antidepressant treatment in primary care. Med Care 1992; 3: 67–76
Trivedi MH, Kleiber BA: Algorithm for the treatment of chronic depression. J Clin Psychiatry 2001; 62(suppl 6): 22–29
Strain JJ, Graeme CS, Hammer JS, et al: Adjustment disorder: a multisite study of its utilization and interventions in the consultation-liaison psychiatry setting. Gen Hosp Psychiatry 1998; 20: 139–149
Guidelines for Pharmacotherapy Follow Up Visits and Quality of Care in ASCP Psychopharmacology Curriculum Third ed. Glen Oaks, American Society of Clinical Psychopharmacology, 2004
Denton GD, Smith J, Faust J, et al: Comparing the efficacy of staff versus housestaff instruction in an intervention to improve hypertension management. Acad Med 2001; 76: 1257–1260
Fox CH, Mahoney MC: Improving diabetes preventive care in a family practice residency program: a case study in continuous quality improvement. Fam Med 1998; 30: 441–445
Keim DB, Gomez CF, Wolf AM: The level of preventive health care in an internal medicine residency clinic: still only an ounce of prevention? South Med J 1998; 91: 550–554
Kerr EA, McGlynn EA, Adams J, et al: Profiling the quality of care in twelve communities: results from the CQI study. Health Aff (Millwood) 2004; 23: 247–256
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Dew, R.E., Kramer, S.I. & McCall, W.V. Adequacy of Antidepressant Treatment by Psychiatric Residents: The Antidepressant Treatment History Form as a Possible Assessment Tool. Acad Psychiatry 29, 283–288 (2005). https://doi.org/10.1176/appi.ap.29.3.283
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DOI: https://doi.org/10.1176/appi.ap.29.3.283