Magazine article Clinical Psychiatry News

Algorithms Promise Better Mental Health Care

Magazine article Clinical Psychiatry News

Algorithms Promise Better Mental Health Care

Article excerpt

SANTA FE, N.M. -- Algorithmic medicine outscored "treatment as usual" in a three-module study involving patients with major depression, bipolar disorder, and schizophrenia, Dr. John Rush reported at a symposium on mood disorders sponsored by the University of Arizona.

Algorithms are not new to medicine, noted Dr. Rush, professor and vice chairman for research in the department of psychiatry at the University of Texas Southwestern Medical Center at Dallas. They have been used in general medicine for decades in an effort to "improve the quality of care, and to increase the value of the health care dollar." The field of psychiatry, however, only recently has begun to develop and evaluate algorithmic protocols.

"The aim of treatment is remission," Dr. Rush told this newspaper. "If you don't have a remission, you adjust the treatment." The algorithmic principles involve starting with the simplest medicines known to be effective, well tolerated, and easy to use, and then supplementing treatment with clinical opinion.

Patient outcomes are measured at the beginning of the trial and again at critical decision points--usually after 4-6 weeks of treatment--to assess the symptomatic benefit of treatment, and to adjust it according to outcome assessment. Physicians are afforded multiple treatment options at each stage of the algorithm.

The three trials headed by Dr. Rush under the Texas Medical Algorithm Project compared treatment as usual with algorithm-driven care using evidence-based guidelines provided by either the American Psychiatric Association or the Agency for Health Care Policy and Research. …

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