摘要:

&NA;

ISSN:1076-5417    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

The author describes the increasingly important role of pharmacoeconomic analysis in the allocation of health care resources today and provides an overview of pharmacoeconomic principles and methods to help mental health professionals better interpret the results of these types of analyses. He begins with a discussion of the limitations of clinical drug development trials for determining actual treatment effectiveness and then describes the more inclusive approach employed in pharmacoeconomic analysis. The need to establish research guidelines and improved pharmacoeconomic methodology is then discussed, as well as the importance of quality of life and functional assessments in this type of analysis. The author presents a cost-effectiveness analysis of two hypothetical anti-depressants to illustrate how pharmacoeconomic analysis is done and some of the problems involved. He reviews some of the major pharmacoeconomic literature on antidepressants published in recent years. The need to extend economic analysis from pharmacological treatments to all clinical treatment modalities (e.g., psychotherapy) is briefly discussed and will dealt with in more detail in a later article. The article concludes with a call for mental health care providers to take a more active role in pharmacoeconomics research so that they can assure that access to the best treatment options is maintained.

ISSN:1076-5417    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

The authors first discuss the incidence and characteristics of refractory depression. They outline questions clinicians should ask when a depressed patient does not respond to an antidepressant (e.g., about the adequacy of the trial; the patient's compliance with medication; comorbid medical illnesses or substance abuse; other medications the patient is taking; the correctness of the diagnosis; the presence of psychotic features, bipolar illness, or recurrent brief depression; family issues; and the nature of the doctor-patient relationship). A general approach to the treatment of refractory depression is then given, including dealing with comorbid substance abuse, family issues, and psychological factors that may be complicating treatment. The authors review specific treatment strategies for refractory unipolar depression, including dosage adjustments, augmentation strategies, changing or combining antidepressants, and electroconvulsive therapy (ECT). They then discuss strategies for treating refractory bipolar depression, including the cautious use of antidepressants, the use of one or more mood stabilizers, augmentation strategies, and ECT. The article concludes with a discussion of the need for maintenance therapy in refractory depression.

ISSN:1076-5417    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

In the second half of this two-part article, the authors review the current state of knowledge about the treatment of attention-deficit/hyperactivity disorder (ADHD) across the lifespan. They first discuss general principles of pharmacotherapy for ADHD and then review the use of the psychostimulants, as well as nonstimulant medications, for ADHD. A strong case is made for including psychosocial interventions in any treatment plan in order to address the complex set of treatment targets that characterize the typical patient with ADHD. The authors review the types of psychosocial interventions that have been found most effective in ADHD, focusing especially on parent training and pedagogical/behavioral school interventions. The article concludes with a discussion of how to combine psychophar-macological treatments and psychosocial interventions most effectively and how to treat ADHD patients whose conditions are complicated by comorbid disorders.

ISSN:1076-5417    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

The author, coordinator of research, evaluation and quality assurance for U.S. Behavioral Health, explains quality assurance monitoring, how it differs from utilization review, and its role in managed mental health care. She then discusses the principles she applies in reviewing network providers' quality of care and describes how she uses a biopsy-chosocial perspective to evaluate treatment planning and outcomes. She explains the types of problems in documentation that cause her to question the quality of the care being provided and the steps she takes to obtain further information and improve quality. The author then discusses four case studies that illustrate the types of issues that arise in quality assurance monitoring. The article concludes with the author's suggestions for how providers can best document care, work with managed care reviewers, and constructively influence the managed care organizations with which they work.

ISSN:1076-5417    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

&NA;

ISSN:1076-5417    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

&NA;

ISSN:1076-5417    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

&NA;

ISSN:1076-5417    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

&NA;

ISSN:1076-5417    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

&NA;

ISSN:1076-5417    

出版商:OVID    

年代:1996

数据来源: OVID