Good morning. On March 13, President Clinton accepted the report of the National Advisory Commission on Consumer Protection and Quality in the Health Care Industry. In his remarks, he noted that for all of the strengths of the American health care system, many gaps still exist. He challenged all of us to "seize this moment of opportunity to improve the quality of health care for all our people."
The landmark study on schizophrenia that we are releasing today is a move toward meeting the President's challenge (select for press release). The findings of this research provide critical information needed to improve the quality of care—and the quality of life—for people with schizophrenia. This study (1, 2) gives clinicians, patients, and their families the basic, evidence-based information they need to formulate a comprehensive treatment plan for their patients with schizophrenia.
This study represents a collaboration between two Government agencies and, ultimately, the private sector. I am proud that AHCPR was able to fund this project jointly with the National Institute of Mental Health, and that the National Alliance for the Mentally Ill has built on the findings to work directly with patients and their families.
The study is one of AHCPR's Patient Outcomes Research Teams, or PORTs, which examine the effectiveness and cost-effectiveness of available treatments for common clinical conditions. AHCPR's 25 PORTs focus on procedures and treatments whose use in the "real world" setting of medical practice has not been rigorously examined.
The schizophrenia PORT identified room for improvement in the care of people with this devastating disease. Dr. Lehman and his team found that less than 50 percent of patients are receiving appropriate doses of antipsychotic medications. They also found gaps in the use and availability of psychosocial and vocational therapies and family interventions.
In the year since I joined AHCPR, I have often been asked what health services research is and how it can change the every day practice of medicine. This study provides a very good answer. Dr. Lehman's team have done what good health services researchers should do: They identified the evidence for treating an important health problem and evaluated the quality of the evidence. They knew that the evidence for quality of care depends on the quality of the evidence. Then they assessed existing patterns of care for people with schizophrenia. Where there are gaps between what we do and what we should do for our patients, then health care research provides clear opportunities for improvement.
These are two essential pieces of the puzzle of improving the quality of health care—evaluating the scientific foundation to identify best practice, in this case for schizophrenia, and comparing it with current practice. These are necessary steps before taking the third step in improving the quality of care for people with schizophrenia.
The third step is the adoption and implementation of this evidence into all aspects of care for people with schizophrenia. This includes community-based care, family education and support, and proper medication. Dr. Lehman and his team emphasize the importance of therapies and interventions other than medication. However, they note that behavioral interventions have not been studied as extensively and rigorously as pharmacological treatments. Dr. Lehman will describe the findings of the study in a few moments.
We are pleased that the National Alliance for the Mentally Ill has embraced the findings of this study, and plans to promote the findings of this research throughout its network of patients, families and affiliated organizations. That kind of collaboration with private sector leaders makes me convinced that we have served the public well by investing our research funds in this area. I expect clinicians and other providers to use this evidence to provide the best possible care for people with schizophrenia.
I would like to commend Dr. Lehman and his team for an excellent study. My goal for AHCPR is to continue to fund work like Dr. Lehman's—innovative, evidence-based research from the best and brightest in health services research.
1. Lehman AF, Steinwachs DM, and Co-Investigators of the PORT Project. Translating research into practice: The schizophrenia Patient Outcomes Research Team (PORT) treatment recommendations. Schizophrenia Bulletin 24(1): 1-10, 1998.
2. Lehman AF, Steinwachs DM, and Survey Co-Investigators of the PORT Project. Patterns of usual care for schizophrenia: Initial results from the schizophrenia Patient Outcomes Research Team (PORT) Client Survey. Schizophrenia Bulletin 24(1): 11-20, 1998
Current as of March 24, 1998
Internet Citation:
Schizophrenia PORT Results Provide Evidence-based Treatment Information. Speech by John Eisenberg, MD, AHCPR Administrator, March 24, 1998. Agency for Health Care Policy and Research, Rockville, MD. http://www.ahrq.gov/news/spschiz.htm
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