Texas Medication Algorithm Project

Development and feasibility testing of a treatment algorithm for patients with bipolar disorder

T. Suppes, A. C. Swann, E. B. Dennehy, E. D. Habermacher, M. Mason, M. L. Crismon, M. G. Toprac, A. J. Rush, S. P. Shon, K. Z. Altshuler

Research output: Contribution to journalArticle

62 Citations (Scopus)

Abstract

Background: Use of treatment guidelines for treatment of major psychiatric illnesses has increased in recent years. The Texas Medication Algorithm Project (TMAP) was developed to study the feasibility and process of developing and implementing guidelines for bipolar disorder, major depressive disorder, and schizophrenia in the public mental health system of Texas. This article describes the consensus process used to develop the first set of TMAP algorithms for the Bipolar Disorder Module (Phase 1) and the trial testing the feasibility of their implementation in inpatient and outpatient psychiatric settings across Texas (Phase 2). Method: The feasibility trial answered core questions regarding implementation of treatment guidelines for bipolar disorder. A total of 69 patients were treated with the original algorithms for bipolar disorder developed in Phase 1 of TMAP. Results: Results support that physicians accepted the guidelines, followed recommendations to see patients at certain intervals, and utilized sequenced treatment steps differentially over the course of treatment. While improvements in clinical symptoms (24-item Brief Psychiatric Rating Scale) were observed over the course of enrollment in the trial, these conclusions are limited by the fact that physician volunteers were utilized for both treatment and ratings, and there was no control group. Conclusion: Results from Phases 1 and 2 indicate that it is possible to develop and implement a treatment guideline for patients with a history of mania in public mental health clinics in Texas. TMAP Phase 3, a recently completed larger and controlled trial assessing the clinical and economic impact of treatment guidelines and patient and family education in the public mental health system of Texas, improves upon this methodology.

Original languageEnglish (US)
Pages (from-to)439-447
Number of pages9
JournalJournal of Clinical Psychiatry
Volume62
Issue number6
StatePublished - 2001

Fingerprint

Bipolar Disorder
Guidelines
Mental Health
Public Health
Therapeutics
Psychiatry
Brief Psychiatric Rating Scale
Physicians
Controlled Clinical Trials
Major Depressive Disorder
Feasibility Studies
Patient Education
Inpatients
Volunteers
Schizophrenia
Consensus
Outpatients
Economics
Control Groups

ASJC Scopus subject areas

  • Psychiatry and Mental health
  • Clinical Psychology

Cite this

Texas Medication Algorithm Project : Development and feasibility testing of a treatment algorithm for patients with bipolar disorder. / Suppes, T.; Swann, A. C.; Dennehy, E. B.; Habermacher, E. D.; Mason, M.; Crismon, M. L.; Toprac, M. G.; Rush, A. J.; Shon, S. P.; Altshuler, K. Z.

In: Journal of Clinical Psychiatry, Vol. 62, No. 6, 2001, p. 439-447.

Research output: Contribution to journalArticle

Suppes, T, Swann, AC, Dennehy, EB, Habermacher, ED, Mason, M, Crismon, ML, Toprac, MG, Rush, AJ, Shon, SP & Altshuler, KZ 2001, 'Texas Medication Algorithm Project: Development and feasibility testing of a treatment algorithm for patients with bipolar disorder', Journal of Clinical Psychiatry, vol. 62, no. 6, pp. 439-447.
Suppes, T. ; Swann, A. C. ; Dennehy, E. B. ; Habermacher, E. D. ; Mason, M. ; Crismon, M. L. ; Toprac, M. G. ; Rush, A. J. ; Shon, S. P. ; Altshuler, K. Z. / Texas Medication Algorithm Project : Development and feasibility testing of a treatment algorithm for patients with bipolar disorder. In: Journal of Clinical Psychiatry. 2001 ; Vol. 62, No. 6. pp. 439-447.
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