Patterns of Usual Care for Schizophrenia: Initial Results From the Schizophrenia Patient Outcomes Research Team (PORT) Client Survey

TLDR

The study surveyed 719 schizophrenia patients in two states to assess how well usual care aligns with PORT treatment recommendations. The survey covered acute inpatient and outpatient programs in urban and rural settings, using medical record reviews and patient interviews to evaluate conformance with 12 PORT treatment recommendations. Conformance rates were generally below 50%, higher for pharmacological than psychosocial treatments, better in rural than urban areas, lower among minorities, and varied by state, highlighting a substantial gap between evidence-based guidelines and current practice.

Abstract

To examine the conformance of current patterns of usual care for persons with schizophrenia to the Schizophrenia Patient Outcomes Research Team (PORT) Treatment Recommendations, the PORT surveyed a stratified random sample of 719 persons diagnosed with schizophrenia in two States. The types of treatment settings surveyed included acute inpatient programs and continuing outpatient programs in urban and rural locales. Using data from medical record reviews and patient interviews, the PORT assessed the conformance of current care with 12 of the Treatment Recommendations. The rates at which patients' treatment conformed to the recommendations were modest at best, generally below 50 percent. Conformance rates were higher for pharmacological than for psychosocial treatments and in rural areas than in urban ones. Rates of Treatment Recommendation conformance for minority patients were lower than those for Caucasians, and patterns of care varied between the two States. The findings indicate that current usual treatment practices likely fall substantially short of what would be recommended based on the best evidence on treatment efficacy. This disparity underscores the need for greater efforts to ensure that treatment research results are translated into practice.