The Antipsychotic Medication Management Fidelity Scale: Psychometric properties

Ruud, Torleif; Drivenes, Karin; Drake, Robert E.; Haaland, Vegard Øksendal; Landers, Matthew; Stensrud, Bjørn; Heiervang, Kristin Sverdvik; Tanum, Lars; Bond, Gary R.

doi:10.1007/s10488-020-01018-1

Cited by 9 publications

(10 citation statements)

References 34 publications

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“…One of the 15 subscales in the fidelity measurement tool for antipsychotic medication is the use of SDM [26]. Thus, the study's implementation support included SDM practice and 14 other components.…”

Section: Implementation Support and Trainingmentioning

confidence: 99%

Mental health professionals’ experiences with shared decision-making for patients with psychotic disorders: a qualitative study

Haugom

Stensrud

Beston³

et al. 2020

BMC Health Serv Res

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Background Shared decision-making (SDM) is a process whereby clinicians and patients work together to select treatments based on both the patient’s preferences and clinical evidence. Although patients with psychotic disorders want to participate more in decisions regarding their care, they have limited opportunities to do so because of various barriers. Knowing about health professionals’ experiences with SDM is important toward achieving successful implementation. The study aim was to describe and explore health professionals’ SDM experiences with patients with psychotic disorders. Methods Three focus group interviews were conducted, with a total of 18 health professionals who work at one of three Norwegian community mental health centres where patients with psychotic disorders are treated. We applied a descriptive and exploratory approach using qualitative content analysis. Results Health professionals primarily understand the SDM concept to mean giving patients information and presenting them with a choice between different antipsychotic medications. Among the barriers to SDM, they emphasized that patients with psychosis have a limited understanding of their health situation and that time is needed to build trust and alliances. Health professionals mainly understand patients with psychotic disorders as a group with limited abilities to make their own decisions. They also described the concept of SDM with little consideration of presenting different treatment options. Psychological or social interventions were often presented as complementary to antipsychotic medications, rather than as an alternative to them. Conclusion Health professionals’ understanding of SDM is inconsistent with the definition commonly used in the literature. They consider patients with psychotic disorders to have limited abilities to participate in decisions regarding their own treatment. These findings suggest that health professionals need more theoretical and practical training in SDM.

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Section: Implementation Support and Trainingmentioning

confidence: 99%

Mental health professionals’ experiences with shared decision-making for patients with psychotic disorders: a qualitative study

Haugom

Stensrud

Beston³

et al. 2020

BMC Health Serv Res

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“…Table 1 shows a brief description or components of each of the four practices. Previous papers described the four practices in greater detail (Egeland et al, 2020 ; Joa et al, 2020 ; Ruud, 2020a , b ).…”

Section: Methodsmentioning

confidence: 99%

The Effect of Intensive Implementation Support on Fidelity for Four Evidence-Based Psychosis Treatments: A Cluster Randomized Trial

Ruud

Drake

Benth

et al. 2021

Adm Policy Ment Health

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Purpose Service providers need effective strategies to implement evidence-based practices (EBPs) with high fidelity. This study aimed to evaluate an intensive implementation support strategy to increase fidelity to EBP standards in treatment of patients with psychosis. Methods The study used a cluster randomized design with pairwise assignment of practices within each of 39 Norwegian mental health clinics. Each site chose two of four practices for implementation: physical health care, antipsychotic medication management, family psychoeducation, illness management and recovery. One practice was assigned to the experimental condition (toolkits, clinical training, implementation facilitation, data-based feedback) and the other to the control condition (manual only). The outcome measure was fidelity to the EBP, measured at baseline and after 6, 12, and 18 months, analyzed using linear mixed models and effect sizes. Results The increase in fidelity scores (within a range 1–5) from baseline to 18 months was significantly greater for experimental sites than for control sites for the combined four practices, with mean difference in change of 0.86 with 95% CI (0.21; 1.50), p = 0.009). Effect sizes for increase in group difference of mean fidelity scores were 2.24 for illness management and recovery, 0.68 for physical health care, 0.71 for antipsychotic medication management, and 0.27 for family psychoeducation. Most improvements occurred during the first 12 months. Conclusions Intensive implementation strategies (toolkits, clinical training, implementation facilitation, data-based feedback) over 12 months can facilitate the implementation of EBPs for psychosis treatment. The approach may be more effective for some practices than for others.

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“…Another observation is that, on the whole, the psychometric properties of the scales examined were found to be satisfactory. However, the fidelity scales that have been around for some time—addressing Family Psychoeducation (FPE; Joa et al 2020 ), Illness Management and Recovery (IMR; Egeland et al 2019 ) and the General Organizational Index (GOI; Heiervang et al 2020 )—overall had slightly better results than those that have been developed more recently for physical healthcare (Ruud et al 2020a ) and antipsychotic medication management (Ruud et al 2020b ). This is probably due, at least in part, to the fact that the earlier scales have a longer history of testing and improvement.…”

Section: Fidelity Scales Examined In Norwaymentioning

confidence: 99%

“…With regard to the more recent scales, the assessed practices were more successful in establishing policies specifying standards for physical healthcare than they were in implementing these policies in daily practice (Ruud et al 2020a ). However, the reverse was true with regard to the scale for antipsychotic medication management: the implementation of prescriber fidelity was slightly more successful than was the implementation of policy fidelity (Ruud et al 2020b ).…”

Section: Fidelity Scales Examined In Norwaymentioning

confidence: 99%

Fidelity Scale: From Black Box to Holy Grail

Weeghel

2020

Adm Policy Ment Health

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Fidelity scales are indispensable in the pursuit of evidence-based mental healthcare. Without fidelity checks, treatment remains a mysterious black box. The aim of this article is to comment on the studies in this special section, and to discuss some general issues with regard to fidelity assessment. Despite all of their supposed benefits, resistance to fidelity scales persists among mental health practitioners. One way to overcome this resistance is to conduct fidelity assessments in the context of a well-guided learning community. The predictive validity of fidelity scales is considered the single most valuable attribute of these instruments. Research on predictive validity requires large sample sizes, which is difficult to achieve. It should nevertheless not prevent us from rigorously searching for this Holy Grail of fidelity assessment. In addition, fidelity assessment should be placed in a broader perspective. The quality of care for people with severe mental illness cannot be assessed conclusively according to the extent to which separate interventions have been applied with good fidelity. These individuals need access to high-quality treatment and support systems within the community, which can enable them to live their lives as valued citizens. In conclusion, fidelity assessment, both at the level of interventions and systems, contributes to a highly desirable transparency in practice variations within the field of mental healthcare.

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The Antipsychotic Medication Management Fidelity Scale: Psychometric properties

Cited by 9 publications

References 34 publications

Mental health professionals’ experiences with shared decision-making for patients with psychotic disorders: a qualitative study

Mental health professionals’ experiences with shared decision-making for patients with psychotic disorders: a qualitative study

The Effect of Intensive Implementation Support on Fidelity for Four Evidence-Based Psychosis Treatments: A Cluster Randomized Trial

Fidelity Scale: From Black Box to Holy Grail

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