Korean J Psychopharmacol.
2006 Jan;17(1):35-49.
The Feasibility Test of Korean Medication Algorithm for the Treatment with Schizophrenic Patients(II): The Problem for Applying Algorithm to the Real Clinical Situation and Opinion of Revision
- Affiliations
-
- 1Department of Psychiatry, Seoul National University College of Medicine, Seoul, Korea. kwonjs@snu.ac.kr
- 2Institute of Human Behavioral Medicine, Seoul National University College of Medicine, Seoul, Korea.
- 3Department of Psychiatry, The Catholic University of Korea College of Medicine, Seoul, Korea.
- 4Department of Psychiatry, School of Medicine, Inha University, Incheon, Korea.
- 5Department of Psychiatry, Kangwon National University College of Medicine, Kangwon National University Hospital, Chunchon, Korea.
- 6Department of Neuropsychiatry, School of Medicine, Wonkwang University, Iksan, Korea.
- 7Department of Psychiatry, Hallym University College of Medicine, Kang-Nam Sacred Heart Hospital, Seoul, Korea.
- 8Department of Psychiatry, Eulji University College of Medicine, Eulji University Hospital, Daejeon, Korea.
- 9Chookryung Evangelic Hospital, Namyangju, Korea.
- 10Department of Psychiatry, National Health Insurance Corporation Ilsan Hospital, Seoul, Korea.
- 11Department of Psychiatry, Institute for Medical Science, College of Medicine, Chonbuk National University, Chonju, Korea.
- 12Department of Psychiatry, Dongguk Universivity College of Medicine, Seoul, Korea.
- 13Severance Mental Health Hospital, Yonsei University College of Medicine, Gyeonggi, Korea.
- 14Department of Psychiatry, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea.
- 15St. Andrew's Neuropsychiatric Hospital, Icheon, Korea.
- 16Department of Neuropsychiatry, Kwangju Severance Psychiatric Hospital, Yonsei University College of Medicine, Gwangju, Korea.
- 17Feasibility of Korean Medication Algorithm for Schizophrenia Project Group, Korea.
Abstract
OBJECTIVES
The Korean College of Neuropsychopharmacology and the Korean Academy of Schizophrenia developed the Korean medication algorithm project for schizophrenia (KMAP) to aid clinical decisions. The purpose of this study was to investigate problems and revision of Korean Medication Algorithm for Schizophrenia after feasibility test.
METHODS
A total of 108 schizophrenia patients were enrolled at 19 centers and treated according to the algorithm. Prescribing investigators were able to change the recommended treatment strategies of the algorithm if necessary. All subjects were assessed over a 4-month period. Appropriateness of choice, dosage, duration and switch of antipsychotics and definition of treatment response were examined.
RESULTS
Compliance of 1(st) choice antipsychotics in KMAP was favorable. Atypical antipsychotics which is a 1(st) stage drug selected first was above 84%, especially in case of no previous medical history was nearly all. In case that shift of stage was needed, there is a trend that combination treatment stage (6(th) stage) and clozapine treatment stage (5(th) stage) were preferred to rather than 3(rd) stage and 4(th) stage (typical antipsychotics and atypical antipsychotics treatment stage). The rates of switching antipsychotics at the time points other than CDP (critical decision points) was low and the reason was almost the side effects. So the compliance of CDPs in KMAP was good in case of insufficiency of treatment response. Also the reasons why many investigators continued using current antipsychotics without switching despite insufficiency of treatment response were definition of treatment response, discrepancy between brief symptom rating scale for negative symptom and decision of clinicians. In addition, compliance of co-existence symptoms and side effect of medication in KMAP was favorable.
CONCLUSION
It is some difference from clinical practice such as stage of antipsychotics, definition of treatment response and usefulness of brief symptom rating scale for negative symptom. But the majority apart from points of preceding paragraph is feasible in clinical practice. These results are essential to revise the next version of KMAP.
- Full Text Links
-
- Actions
-
Cited
- CITED
-
- Close
- Share
-
- Similar articles
-
- The Consideration for Revision of the Korean Medication Algorithm for Schizophrenia
- The Feasibility Test of Korean Medication Algorithm for the Treatment with Schizophrenic Patients(IV): Influences of a History of Antipsychotic Treatment on Effectiveness and Algorithm Application
- The Feasibility Test of Korean Medication Algorithm for the Treatment with Schizophrenic Patients(III): The Influence of Therapeutic Environment on Application of Korean Medication Algorithm Project for Schizophrenia
- Korean Medication Algorithm for Bipolar Disorder: Revision and Further Suggestion
- Designs and Methods for the Development of Korean Medication Algorithm for Schizophrenic Patients
