Implementation of the Texas Medication Algorithm Project patient and family education program

Marcia G. Toprac, Ellen B. Dennehy, Thomas J. Carmody, M. Lynn Crismon, Alexander L. Miller, Madhukar H. Trivedi, Trisha Suppes, A. John Rush

Research output: Contribution to journalArticle

16 Citations (Scopus)

Abstract

Objective: This article describes the implementation and utilization of the patient and family education program (PFEP) component of the Texas Medication Algorithm Project (TMAP). The extent of participation, types of psychoeducation received, and predictors of receiving at least a minimum level of education are presented. Method: TMAP included medication guidelines, a dedicated clinical coordinator, standardized assessments of symptoms and side effects, uniform documentation, and a PFEP. The PFEP includes phased, multimodal, disorder-specific educational materials for patients and families. Participants were adult outpatients of 1 of 7 community mental health centers in Texas that were implementing the TMAP disease management package. Patients had DSM-IV clinical diagnoses of major depressive disorder, with or without psychotic features; bipolar I disorder or schizoaffective disorder, bipolar type; or schizophrenia or schizoaffective disorder. Assessments were administered by independent research coordinators. Study data were collected between March 1998 and March 2000, and patients participated for at least 1 year. Results: Of the 487 participants, nearly all (95.1%) had at least 1 educational encounter, but only 53.6% of participants met criteria for "minimum exposure" to individual education interventions. Furthermore, only 31.0% participated in group education, and 42.5% had a family member involved in at least 1 encounter. Participants with schizophrenia were less involved in the PFEP across multiple indicators of utilization. Diagnosis, intensity of symptoms, age, and receipt of public assistance were related to the likelihood of exposure to minimum levels of individual education. Conclusion: Despite adequate resources and infrastructure to provide PFEP, utilization was less than anticipated. Although implementation guidelines were uniform across diagnoses, participants with schizophrenia experienced less exposure to psychoeducation. Recommendations for improving program implementation and modification of materials are discussed.

Original languageEnglish (US)
Pages (from-to)1362-1372
Number of pages11
JournalJournal of Clinical Psychiatry
Volume67
Issue number9
StatePublished - Sep 2006

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Patient Education
Education
Schizophrenia
Psychotic Disorders
Public Assistance
Guidelines
Community Mental Health Centers
Symptom Assessment
Major Depressive Disorder
Disease Management
Bipolar Disorder
Diagnostic and Statistical Manual of Mental Disorders
Documentation
Outpatients
Research

ASJC Scopus subject areas

  • Psychiatry and Mental health
  • Clinical Psychology

Cite this

Toprac, M. G., Dennehy, E. B., Carmody, T. J., Crismon, M. L., Miller, A. L., Trivedi, M. H., ... Rush, A. J. (2006). Implementation of the Texas Medication Algorithm Project patient and family education program. Journal of Clinical Psychiatry, 67(9), 1362-1372.

Implementation of the Texas Medication Algorithm Project patient and family education program. / Toprac, Marcia G.; Dennehy, Ellen B.; Carmody, Thomas J.; Crismon, M. Lynn; Miller, Alexander L.; Trivedi, Madhukar H.; Suppes, Trisha; Rush, A. John.

In: Journal of Clinical Psychiatry, Vol. 67, No. 9, 09.2006, p. 1362-1372.

Research output: Contribution to journalArticle

Toprac, MG, Dennehy, EB, Carmody, TJ, Crismon, ML, Miller, AL, Trivedi, MH, Suppes, T & Rush, AJ 2006, 'Implementation of the Texas Medication Algorithm Project patient and family education program', Journal of Clinical Psychiatry, vol. 67, no. 9, pp. 1362-1372.
Toprac, Marcia G. ; Dennehy, Ellen B. ; Carmody, Thomas J. ; Crismon, M. Lynn ; Miller, Alexander L. ; Trivedi, Madhukar H. ; Suppes, Trisha ; Rush, A. John. / Implementation of the Texas Medication Algorithm Project patient and family education program. In: Journal of Clinical Psychiatry. 2006 ; Vol. 67, No. 9. pp. 1362-1372.
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