As such, PORT recommendations have been applied to evaluate the quality of care provided to people with schizophrenia in a variety of treatment settings. Also, in contrast to the APA Practice Guideline and the algorithms developed by TMAP, the PORT provides clear-cut and concise statements of recommendations for best practices. However, unlike TMAP, the PORT includes recommendations for adjunctive psychopharmacologic treatments as well as for antipsychotic medications, and also includes recommendations for psychosocial interventions, which are important treatments that augment gains from medication therapies. By remaining silent on a number of aspects of care for schizophrenia for which empirical support is currently lacking, the PORT is known for being relatively conservative. Although expert opinion is sought to reach consensus on the interpretation of the evidence base for a particular treatment, there are no PORT treatment recommendations based solely on expert opinion, as is the case with other efforts designed to specify best practices for schizophrenia (eg, the American Psychiatric Association Practice Guideline for the Treatment of Patients with Schizophrenia, 3 the Texas Medication Algorithm Project ). 2 The PORT recommendations are readily distinguishable from other clinical guidelines and algorithms for schizophrenia because only those treatments for which there is substantial scientific evidence achieve recommendation status. To improve the quality of medical care for these disorders, the PORT program sought to reduce variations in care by promoting the adoption of treatments supported by strong scientific evidence or “evidence-based practices.” To achieve this goal, the various PORTs synthesized the clinical evidence pertaining to many common medical conditions and produced treatment recommendations and other types of evidence-based clinical guidelines to be disseminated to both consumers and clinicians.Īs a part of the initial Schizophrenia PORT project, investigators conducted systematic reviews of the literature to identify evidence-based practices for the care of persons with schizophrenia, from which the first Schizophrenia PORT treatment recommendations were developed and published in 1998 1 and subsequently updated in 2003. The Schizophrenia PORT was 1 of 14 Patient Outcomes Research Teams created in the late 80s and early 90s in response to concerns raised about the appropriateness of care being delivered for several common medical and psychiatric conditions, including schizophrenia. In 1992, the Agency for Health Care Policy and Research (now the Agency for Healthcare Research and Quality ) and the National Institute of Mental Health (NIMH) funded the Schizophrenia Patient Outcomes Research Team (PORT) Study. Another 13 psychopharmacologic and 4 psychosocial treatments had insufficient evidence to support a recommendation, representing significant unmet needs in important treatment domains.Įvidence-based practices, psychopharmacologic treatments, psychosocial interventions Introduction The methods and outcomes of the update process are presented here and resulted in recommendations for 16 psychopharmacologic and 8 psychosocial treatments for schizophrenia. An Expert Panel consisting of 39 schizophrenia researchers, clinicians, and consumers attended a conference in November 2008 in which consensus was reached on the state of the evidence for each of the treatment areas reviewed. For those treatments lacking empirical support, the ERGs produced parallel summary statements. The ERGs reviewed over 600 studies and synthesized the research evidence, producing recommendations for those treatments for which the evidence was sufficiently strong to merit recommendation status. The ERGs also reviewed studies preceding 2002 in areas not covered by previous PORT reviews, including smoking cessation, substance abuse, and weight loss. In consultation with expert advisors, 2 Evidence Review Groups (ERGs) identified 41 treatment areas for review and conducted electronic literature searches to identify all clinical studies published since the last PORT literature review. Over the last 5 years, research on psychopharmacologic and psychosocial treatments for schizophrenia has continued to evolve, warranting an update of the PORT recommendations. In contrast to other clinical guidelines, the Schizophrenia PORT Treatment Recommendations, initially published in 1998 and first revised in 2003, are based primarily on empirical data. The Schizophrenia Patient Outcomes Research Team (PORT) project has played a significant role in the development and dissemination of evidence-based practices for schizophrenia.
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