Prescriber Fidelity to a Medication Management Evidence-Based Practice in the Treatment of Schizophrenia
Howard PB et al. - Implementation and monitoring of MedMAP were feasible in these community mental health settings. Additional implementation projects are crucial for advancing evidence-based practice in clinical settings.
Methods
- This three-year longitudinal intervention study implemented MedMAP in six community mental health centers in Kentucky.
- Nine psychiatrists and five advanced practice psychiatric nurses with prescriptive authority participated in the study.
- Prescribers were trained in the use of MedMAP about one month before implementation, and MedMAP principles were reinforced throughout the study.
- Four posttraining assessments were conducted at each site at approximately four-month intervals over a period of 30 months.
- An 18-item scale was used to assess baseline and posttraining prescriber fidelity over a period of 30 months in 900 randomly selected medical records.
Results
- Average fidelity scores improved significantly over baseline at each of the four postimplementation fidelity assessments.
- Training effects were most evident at the second posttraining fidelity assessment, but effects persisted over the course of the study.
- There was considerable variability in scores across items both at baseline and subsequently.
- Posttraining improvement was greatest in patient education, documentation of illness and medication history, and simplification of medication regimen.
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