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The 130th Annual Meeting of APHA |
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The 130th Annual Meeting of APHA |
Martin Gittelman, PhD, Psychiatry, NYU School of Medicine, 160 West 94th Street, New York, NY 10025, 212 663-0131, martin.gittelman@med.nyu.edu and Chen Yanfang, Shandong Medical University, NA, Shandong Province, China.
Developing countries have few trained medical specialists but often are rich in extended family networks. This is a report of a 4.5 year randomized controlled study of 853 persons diagnosed with schizophrenia and treated with low dose conventional or newer atypical antipsychotic medication in supervised family based settings in Shandong Province, China.
Selected S's had had multiple acute relapses. Families were selected who were able to follow a protocol and provide a wide range of clinical functions, including clinical observation, medication administration and dosage adjustment. These families were trained by a psychiatrist and supervised directly by primary care health workers and, when required, by psychiatrists. S's were trained and expected to perform usual activities of daily living and part time work, many in a rural context. Families received training and regular supervision and provided daily monitoring of clinical state (positive and negative signs as measured by BPRS) and dose adjustments within a defined protocol. Periodic blood tests were taken following national guidelines.
Results found no significant differences for acute relapse regardless of medication groups with total relapse lower than rates reported for less carefully monitored S's with schizophrenia. Medication and personnel cost effectiveness issues and implications of the use of DOT in developed countries will be discussed.
Learning Objectives:
Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.