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Related Experiment Videos

Texas Medication Algorithm Project: development and feasibility testing of a treatment algorithm for patients with

T Suppes1, A C Swann, E B Dennehy

  • 1Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas 75390-9070, USA. Patricia.Suppes@UTSouthwestern.edu

The Journal of Clinical Psychiatry
|July 24, 2001
PubMed
Summary

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The Texas Medication Algorithm Project (TMAP) demonstrated that treatment guidelines for bipolar disorder are feasible for implementation in public mental health settings. Physician acceptance and adherence were observed, with some clinical improvements noted.

Area of Science:

  • Psychiatry
  • Public Health
  • Clinical Guidelines

Background:

  • Treatment guidelines for major psychiatric illnesses have gained prominence.
  • The Texas Medication Algorithm Project (TMAP) aimed to assess guideline development and implementation for bipolar disorder, major depressive disorder, and schizophrenia within Texas's public mental health system.
  • This study details the consensus process for the Bipolar Disorder Module (Phase 1) and a feasibility trial (Phase 2) in Texas psychiatric settings.

Purpose of the Study:

  • To evaluate the feasibility and process of developing and implementing treatment guidelines for bipolar disorder in a public mental health system.
  • To test the implementation of the TMAP bipolar disorder algorithms in inpatient and outpatient settings.

Main Methods:

  • Development of TMAP algorithms for bipolar disorder through a consensus process (Phase 1).

Related Experiment Videos

  • A feasibility trial involving 69 patients treated with the Phase 1 algorithms in Texas psychiatric settings (Phase 2).

    • Main Results:

    • Physicians accepted the treatment guidelines and adhered to recommended patient follow-up intervals.
    • Sequenced treatment steps were utilized differentially throughout patient care.
    • Observed improvements in clinical symptoms (using the 24-item Brief Psychiatric Rating Scale) were noted, though limited by the absence of a control group and use of volunteer physicians for ratings.

    Conclusions:

    • Developing and implementing treatment guidelines for patients with a history of mania in Texas public mental health clinics is achievable.
    • TMAP Phase 3, a larger controlled trial, builds upon this methodology by assessing clinical and economic impacts and incorporating patient/family education.