title: Adaptation of the Texas Implementation Medication Algorithm for Bipolar Disorder in Adult Female Offenders.
abstract: Use of medication algorithms in the correctional setting may facilitate clinical decision making, improve consistency of care, and reduce polypharmacy. The objective of the present study was to evaluate effectiveness of algorithm (Texas Implementation of Medication Algorithm [TIMA])-driven treatment of bipolar disorder (BD) compared with Treatment as Usual (TAU) in the correctional environment. A total of 61 women inmates with BD were randomized to TIMA (n = 30) or TAU (n = 31) and treated over a 12-week period. The outcome measures included measures of BD symptoms, comorbid symptomatology, quality of life, and psychotropic medication utilization. In comparison with TAU, TIMA-driven treatment reduced polypharmacy, decreased overall psychotropic medication utilization, and significantly decreased use of specific classes of psychotropic medication (antipsychotics and antidepressants). This pilot study confirmed the feasibility and benefits of algorithm-driven treatment of BD in the correctional setting, primarily by enhancing appropriate use of evidence-based treatment.
authors.affiliation: University of Connecticut, Farmington, USA jkamath@uchc.edu.
authors.forename: Jayesh
authors.initials: J
authors.lastname: Kamath
authors.affiliation: University of Connecticut, Farmington, USA.
authors.forename: Sara
authors.initials: S
authors.lastname: Wakai
authors.affiliation: University of Connecticut, Farmington, USA.
authors.forename: Wanli
authors.initials: W
authors.lastname: Zhang
authors.affiliation: Institute of Living, Hartford, CT, USA.
authors.forename: Karen
authors.initials: K
authors.lastname: Kesten
authors.affiliation: University of Connecticut, Farmington, USA.
authors.forename: Deborah
authors.initials: D
authors.lastname: Shelton
authors.affiliation: University of Connecticut, Farmington, USA.
authors.forename: Robert
authors.initials: R
authors.lastname: Trestman
mesh_terms: D000328:Adult; D000465:Algorithms; D001714:Bipolar Disorder / Q000188:drug therapy*; D003237:Connecticut; D019317:Evidence-Based Medicine; D005260:Female; D006801:Humans; D010865:Pilot Projects; D019338:Polypharmacy; D011329:Prisoners; D011619:Psychotropic Drugs / Q000627:therapeutic use*
chemical_list: D011619:Psychotropic Drugs
keywords: algorithm; bipolar disorder; evidence-based pharmacotherapy; polypharmacy; prison