The introduction of the novel antipsychotics has had a major impact upon the treatment of schizophrenia. However, the greater acquisition costs of these drugs puts them beyond the reach of large sectors of the world's population. Consequently, the gap between the levels of care in high-income and low-income countries is likely to widen even further. Co-ordinated global action is necessary to ensure greater accessibility of these drugs. Cost-effectiveness studies in low-income countries need to be undertaken. The considerable evidence for improved safety and efficacy of low-dose compared to high-dose classical antipsychotics offers an alternative that could be implemented immediately in low-income countries.
As a consequence of an increased awareness of quality management in psychiatry the Lundbeck Institute has developed a software program called Psychiatry Quality Measurement (PQM). This is an electronic documentation and quality measurement system with a large data-collecting function to record longitudinal data of the full psychiatric visit, covering all aspects of an evaluation and follow-up. Using the full ICD-10 and DSM-IV classifications, the system has been designed to assist with quality measurement in all psychiatric diagnoses. A full statistical package is included in the program to calculate outcomes of treatment (including relapse rates, improvements in psychopathology, severity and frequency of side-effects, and costs of treatment) as tables and graphs ready for presentation in a Powerpoint format. The system is fully translatable and flexible for various implementation settings, including stand-alone PCs or hospital network systems, all ICD-10 or DSM-IV diagnoses, and the possibility of the use of over 20 psychopathology and side-effect scales to measure the quality of care of all psychiatry patients.
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