Psychiatry - October 2008 - (Page 17)

NEWS FROM MENTAL HEALTH AMERICA Patient Involvement in Healthcare different levels of prior antidepressant experience. Such data suggests that modifiable factors associated with patient knowledge, attitude, and practice— not the use of a specific medication—are the appropriate focus of efforts to improve the effectiveness of antidepressant use and treatment outcomes. For newly treated or lapsed patients, the median time to discontinuation was 67 day versus 187 days for patients who had previously been dispensed an antidepressant. The study was published in the September issue of Clinical Therapeutics and included over 211,000 patients taking SSRI/SNRIs from 1,157 retail pharmacies across the country. Patients in the study received venlafaxine XR, sertraline, paroxetine CR, fluoxetine, escitalopram, or citalopram prescriptions between October 1, 2003 and March 31, 2004. Patients were followed over a year's time. The study was funded by Adheris, Inc. by David Shern, PhD, President and CEO, Mental Health America T he person who has the most at stake when it comes to healthcare decisions— the patient—should be involved in research, advocacy, and all segments of the healthcare system. That’s the key finding of a recent report released by The National Working Group on Evidence-Based Healthcare. The Role of the Patient/Consumer in Establishing a Dynamic Clinical Research Continuum: Models of Patient/Consumer Inclusion describes successful examples of groundbreaking patient/consumer engagement in evidence-based healthcare. Designed for patients/consumers, providers, and decision-makers, this report identifies best practices for meaningfully involving patients/consumers. The report is especially significant given the increased focus on expanding the US capacity for comparative effectiveness research and the potential for a new centralized entity to conduct the research. This past Congress, Senators Max Baucus (D-MT) and Kent Conrad (D-ND), introduced a comparative effectiveness research (CER) bill that would establish a private, nonprofit Healthcare Comparative Effectiveness Research Institute. It would set a national CER agenda, establish processes/protocols and relevant committees, conduct research projects and feasibility studies, and disseminate research. The Institute would be “responsible for setting national priorities” and would contract with NIH, the Agency for Healthcare Research and Quality, and private entities to provide peer-reviewed research studies. It is likely the next Administration and new Congress will pursue this approach. Comparative effectiveness research is often pointed to as a solution to the growing fiscal pressures of healthcare spending. But as this report makes clear, patient/consumer involvement is critical to crafting informed, balanced, and effective healthcare decision-making. From research design to the implementation and evaluation of findings, patients and consumers should have a meaningful role in all aspects of comparative effectiveness research. The report calls for patients and consumers to pursue positions on governing boards to ensure that patient and consumer perspective influences each organization’s activities. It is also important that patients and consumers seek opportunities to influence research topics to ensure that they are relevant and appropriately address their needs. Patient and consumer participation in study design is also essential, according to the report. Research organizations should be accountable for providing patients and consumers with the appropriate resources to successfully engage in study design activities. Additionally, a lack of expertise in a specific discipline should not exclude patients/consumers from participating. With respect to translation and dissemination, the patient/consumer perspective should be incorporated regardless of the intended audience, as it will promote the appropriate use of evidence in advocacy, and maintains the patient/consumer perspective in clinical decisions. Finally, the report urges that patient and consumer perspectives should be emphasized during the implementation phase because it has the most direct impact on the delivery of care. The report builds off a March 2008 Working Group forum that promoted the inclusion of patients and consumers throughout the research process. Five organizations that engage patients/consumers in conducting research are featured in this report, ranging from large, publicly funded health technology assessment groups to small, independent, disease-specific research programs. These organizations highlight a variety of paradigms and best practices for gaining patient and consumer perspectives in research. To download a copy of the report and learn more about the National Working Group on Evidence-Based Health Care, visit http://www.evidencebasedhealthcare.org/. [OCTOBER] Psychiatry 2008 17 http://www.evidencebasedhealthcare.org/

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Psychiatry - October 2008 Editor’s Message Editorial Advisory Board Contents Psych Rx Treatment of Migraine and the Role of Psychiatric Medications Play Therapy: A Case-based Example of a Nondirective Approach Delirium and Antipsychotics: A Systematic Review of Epidemiologyand Somatic Treatment Options Severely Mood-disordered Youth Respond Less Well to Treatment in a Community Clinic than Youth with Bipolar Disorder Beyond Informed Consent: The Ethics of Informing, Anticipating, and Warning Asthma: Wheezing, Woes, and Worries Classified Advertising Journal Watch Information for Authors

Psychiatry - October 2008

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