title: Clinicians' adherence to an algorithm for pharmacotherapy of depression in the Texas public mental health sector.
abstract: This study evaluated clinicians' adherence to the major depressive disorder algorithm of the Texas Implementation of Medication Algorithms (TIMA) as a component of usual care in the Texas public mental health system. Data were collected from two Texas Department of Mental Health and Mental Retardation centers between April and December 2000. Clinician adherence measures included documentation of outcome measures, prescribing patterns (correct medications, therapeutic dosing, dosage increases, and appropriate medication changes), and visit frequency. Clinicians had consistently high adherence to appropriate drug regimens, at appropriate dosages. Variability in attempts to increase dosages when warranted, visit frequency, and documentation of patient outcome measures between clinicians were seen. The results suggest that implementation of medication algorithms is possible in the public mental health sector.
authors.affiliation: College of Pharmacy, The University of Texas at Austin, 78712, USA. bettinger@mail.utexas.edu
authors.forename: Tawny L
authors.initials: TL
authors.lastname: Bettinger
authors.forename: M Lynn
authors.initials: ML
authors.lastname: Crismon
authors.forename: Madhukar H
authors.initials: MH
authors.lastname: Trivedi
authors.forename: Bruce
authors.initials: B
authors.lastname: Grannemann
authors.forename: Steven P
authors.initials: SP
authors.lastname: Shon
mesh_terms: D000328:Adult; D000465:Algorithms; D000928:Antidepressive Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D003866:Depressive Disorder / Q000188:drug therapy*; D004363:Drug Utilization / Q000592:standards*; D005260:Female; D019983:Guideline Adherence; D006801:Humans; D008297:Male; D008485:Medical Audit; D008605:Mental Health Services / Q000592:standards*; D017410:Practice Guidelines as Topic; D011635:Public Health Administration / Q000592:standards*; D012189:Retrospective Studies; D013781:Texas
chemical_list: D000928:Antidepressive Agents