Psychopharmacological treatment in the RAISE-ETP study: Outcomes of a manual and computer decision support system based intervention

Delbert G. Robinson, Nina R. Schooler, Christoph U. Correll, Majnu John, Benji T. Kurian, Patricia Marcy, Alexander L. Miller, Ronny Pipes, Madhukar H. Trivedi, John M. Kane

Research output: Contribution to journalArticle

7 Citations (Scopus)

Abstract

Objective: The Recovery After an Initial Schizophrenia Episode-Early Treatment Program compared NAVIGATE, a comprehensive program for first-episode psychosis, to clinician-choice community care over 2 years. Quality of life and psychotic and depressive symptom outcomes were found to be better with NAVIGATE. Compared with previous comprehensive first-episode psychosis interventions, NAVIGATE medication treatment included unique elements of detailed first-episode-specific psychotropic medication guidelines and a computerized decision support system to facilitate shared decision making regarding prescriptions. In the present study, the authors compared NAVIGATE and community care on the psychotropic medications prescribed, side effects experienced, metabolic outcomes, and scores on the Adherence Estimator scale, which assesses beliefs related to nonadherence. Method: Prescription data were obtained monthly. At baseline and at 3, 6, 12, 18, and 24 months, participants reported whether they were experiencing any of 21 common antipsychotic side effects, vital signs were obtained, fasting blood samples were collected, and the Adherence Estimator scale was completed. Results: Over the 2-year study period, compared with the 181 community care participants, the 223 NAVIGATE participants had more medication visits, were more likely to receive a prescription for an antipsychotic and more likely to receive one conforming to NAVIGATE prescribing principles, and were less likely to receive a prescription for an antidepressant. NAVIGATE participants experienced fewer side effects and gained less weight; other vital signs and cardiometabolic laboratory findings did not differ between groups. Adherence Estimator scores improved in the NAVIGATE group but not in the community care group. Conclusions: As part of comprehensive care services, medication prescription can be optimized for first-episode psychosis, contributing to better outcomes with a lower side effect burden than standard care.

Original languageEnglish (US)
Pages (from-to)169-179
Number of pages11
JournalAmerican Journal of Psychiatry
Volume175
Issue number2
DOIs
StatePublished - Feb 1 2018

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Prescriptions
Outcome Assessment (Health Care)
Psychotic Disorders
Vital Signs
Antipsychotic Agents
Antidepressive Agents
Fasting
Schizophrenia
Decision Making
Quality of Life
Guidelines
Depression
Weights and Measures

ASJC Scopus subject areas

  • Psychiatry and Mental health

Cite this

Psychopharmacological treatment in the RAISE-ETP study : Outcomes of a manual and computer decision support system based intervention. / Robinson, Delbert G.; Schooler, Nina R.; Correll, Christoph U.; John, Majnu; Kurian, Benji T.; Marcy, Patricia; Miller, Alexander L.; Pipes, Ronny; Trivedi, Madhukar H.; Kane, John M.

In: American Journal of Psychiatry, Vol. 175, No. 2, 01.02.2018, p. 169-179.

Research output: Contribution to journalArticle

Robinson, Delbert G. ; Schooler, Nina R. ; Correll, Christoph U. ; John, Majnu ; Kurian, Benji T. ; Marcy, Patricia ; Miller, Alexander L. ; Pipes, Ronny ; Trivedi, Madhukar H. ; Kane, John M. / Psychopharmacological treatment in the RAISE-ETP study : Outcomes of a manual and computer decision support system based intervention. In: American Journal of Psychiatry. 2018 ; Vol. 175, No. 2. pp. 169-179.
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