Kamath Jayesh, Wakai Sara, Zhang Wanli, Kesten Karen, Shelton Deborah, Trestman Robert
University of Connecticut, Farmington, USA
University of Connecticut, Farmington, USA.
Int J Offender Ther Comp Criminol. 2016 Aug;60(11):1315-26. doi: 10.1177/0306624X15578228. Epub 2015 Mar 31.
Use of medication algorithms in the correctional setting may facilitate clinical decision making, improve consistency of care, and reduce polypharmacy. The objective of the present study was to evaluate effectiveness of algorithm (Texas Implementation of Medication Algorithm [TIMA])-driven treatment of bipolar disorder (BD) compared with Treatment as Usual (TAU) in the correctional environment. A total of 61 women inmates with BD were randomized to TIMA (n = 30) or TAU (n = 31) and treated over a 12-week period. The outcome measures included measures of BD symptoms, comorbid symptomatology, quality of life, and psychotropic medication utilization. In comparison with TAU, TIMA-driven treatment reduced polypharmacy, decreased overall psychotropic medication utilization, and significantly decreased use of specific classes of psychotropic medication (antipsychotics and antidepressants). This pilot study confirmed the feasibility and benefits of algorithm-driven treatment of BD in the correctional setting, primarily by enhancing appropriate use of evidence-based treatment.
在惩教环境中使用药物治疗算法可能有助于临床决策，提高护理的一致性，并减少联合用药。本研究的目的是评估在惩教环境中，与常规治疗（TAU）相比，算法驱动的双相情感障碍（BD）治疗（德克萨斯药物治疗算法实施 [TIMA]）的有效性。共有61名患有双相情感障碍的女性囚犯被随机分为TIMA组（n = 30）或TAU组（n = 31），并接受为期12周的治疗。结果指标包括双相情感障碍症状、共病症状、生活质量和精神药物使用情况的测量。与TAU相比，TIMA驱动的治疗减少了联合用药，降低了总体精神药物使用量，并显著减少了特定类别的精神药物（抗精神病药和抗抑郁药）的使用。这项初步研究证实了在惩教环境中采用算法驱动的双相情感障碍治疗的可行性和益处，主要是通过加强基于证据的治疗的合理使用。
