November 28, 2018
Team-based coordinated specialty care (CSC) for first episode psychosis (FEP) resulted in more optimal prescribing of antipsychotics and fewer side effects when compared with typical community care, according to findings from NIMH’s Recovery After an Initial Schizophrenia Episode (RAISE) project. These findings add detail about this component of treatment to findings from the original RAISE Early Treatment Program (RAISE-ETP) study, which found improved treatment outcomes with CSC versus typical care.
Psychosis is used to describe conditions that affect the mind, where there has been some loss of contact with reality. Symptoms of psychosis include delusions (false beliefs) and hallucinations (seeing or hearing things that others do not see or hear). Untreated, psychotic symptoms can lead to disruptions in school and work, strained family relations, and separation from friends. In a series of reports, the RAISE project has provided information on the feasibility and benefits of individualized, timely care for young people with early psychosis.
In the RAISE-ETP study, the research team trained clinical staff, located at clinics around the country, to use a CSC program called NAVIGATE. This program incorporated features aimed specifically at optimizing the prescribing of medication to treat FEP. These features included medication guidelines developed for NAVIGATE; a computer-based support system (COMPASS) to facilitate patient-prescriber communication and shared decision-making; and training and support for prescribers.
Using COMPASS, participants entered information about their symptoms, medication side effects, substance use, treatment preferences, and attitudes towards medication. Providers also entered assessments into COMPASS. Based on patient and provider information, the system suggests treatment strategies, and providers and participants made decisions in the context of this information.