The Texas Medication Algorithm Project Patient and Family Education Program

Toprac, Marcia G.; Rush, A. John; Conner, TM; Crismon, M. Lynn; Dees, M.; Hopkins, Carl E.; Rowe, Victoria; Shon, Steven P.

doi:10.4088/jcp.v61n0704

Cited by 25 publications

(16 citation statements)

References 0 publications

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“…The foundation for the MBC model was developed in the Texas Medication Algorithm Project (TMAP) in 1996. 23 The TMAP approach 24 consists of: (1) evidencebased, consensually approved medication algorithms; (2) clinical and technical support necessary to allow the clinician to use the algorithm; (3) patient programs that allow the patient to be an active partner in care 25 ; and (4) uniform documentation of care provision and patient outcomes. Its model has been quite successful for major depressive disorder in that patients have demonstrated greater depressive symptom reduction and improvement in the SF-12 mental health score compared to treatment as usual groups.…”

Section: Principles Of Mbcmentioning

confidence: 99%

Treating Depression Within the HIV “Medical Home”: A Guided Algorithm for Antidepressant Management by HIV Clinicians

Adams

Gaynes

McGuinness

et al. 2012

AIDS Patient Care and STDs

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People living with HIV/AIDS (PLWHA) suffer increased depression prevalence compared to the general population, which negatively impacts antiretroviral (ART) adherence and HIV-related outcomes leading to morbidity and mortality. Yet depression in this population often goes undiagnosed and untreated. The current project sought to design an evidence-based approach to integrate depression care in HIV clinics. The model chosen, measurement-based care (MBC), is based on existing guidelines and the largest randomized trial of depression treatment. MBC was adapted to clinical realities of HIV care for use in a randomized controlled effectiveness trial of depression management at three academic HIV clinics. The adaptation accounts for drugdrug interactions critical to ongoing ART effectiveness and can be delivered by a multidisciplinary team of nonmental health providers. A treatment algorithm was developed that enables clinically supervised, nonphysician depression care managers (DCMs) to track and monitor antidepressant tolerability and treatment response while supporting nonpsychiatric prescribers with antidepressant choice and dosing. Quality of care is ensured through weekly supervision of DCMs by psychiatrists. Key areas of flexibility that have been important in implementation have included flexibility in timing of assessments, accommodation of divergence between algorithm recommendations and provider decisions, and accommodation of delays in implementing treatment plans. This adaptation of the MBC model to HIV care has accounted for critical antidepressant-antiretroviral interactions and facilitated the provision of quality antidepressant management within the HIV medical home.

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Section: Principles Of Mbcmentioning

confidence: 99%

Treating Depression Within the HIV “Medical Home”: A Guided Algorithm for Antidepressant Management by HIV Clinicians

Adams

Gaynes

McGuinness

et al. 2012

AIDS Patient Care and STDs

View full text Add to dashboard Cite

show abstract

“…The concept of the practitionerÀclient encounter as an explicit negotiation in which the practitioner provides technical advice and the client provides goals and preferences has been prominent for decades (Lazare, Eisenthal, & Wasserman, 1975) and continues to be developed in current psychotherapies. Recently, mental health advocates, professionals, and researchers have endorsed client education and attending to client preferences in terms of medications (Toprac et al, 2000), housing (Carling, 1993), rehabilitation (Anthony, Cohen, & Farkas, 1999), supported education and employment, (Becker & Drake, 2001) and self-directed care (Mueser et al, 2002). The President's New Freedom Commission Report (2003) explicitly endorses client-centered care and the client's preferences for recovery goals (New Freedom Commission on Mental Health, 2003).…”

Section: Shared Decision-making In Mental Healthmentioning

confidence: 99%

Shared Decision-Making and Evidence-Based Practice

Adams

Drake

2006

Community Ment Health J

264

209

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Shared decision-making refers to a process of health care delivery in which practitioners and clients seeking help for problems or disorders collaborate to access relevant information and to enable client-centered selection of health care resources. Though nearly all clients express a desire for more information, preferences for participation in health care decisions vary by individual and by illness. Two common strategies to promote shared decision-making are communication training for clients and clinicians, and decision aids to provide targeted information and values clarification. Research in several areas of medicine shows that active client participation results in a variety of benefits, from increased satisfaction to decreased symptom burden. Many current mental health interventions promote client-centered care, client choice, and self-directed care, but research on shared decision-making in mental health for clients with severe and persistent mental illness is just beginning.

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“…67 This intervention package was intended to optimize pharmacotherapy, thereby enhancing clinical outcomes. Each physician implemented ALGO in close collaboration with a clinical coordinator.…”

Section: Algorithm Interventionmentioning

confidence: 99%