There is substantial evidence that quality of care for schizophrenia falls short of evidence-based standards derived from the clinical research literature. Studies of non-adherence to guidelines for other conditions have found lack of knowledge, disagreement with the evidence, lack of confidence in ability to implement guidelines effectively, and perceived organizational barriers to their implementation. Reasons for the gap between practice and evidence are not known for schizophrenia. This study will address these issues through a survey of psychiatrists providing direct patient.
The aims are: 1) To identify sources of information used by psychiatrists to learn about advances in diagnosis and treatment of psychiatric disorders, 2) To assess the extent of agreement with and adherence to evidence-based guidelines developed in the schizophrenia PORT project, 3) To examine characteristics of psychiatrists, their practices and the external environment associated with readiness to adopt evidence-based guidelines, and 4) To assess the willingness of psychiatrists to participate in educational opportunities to advance their knowledge about and ability to implement guidelines, and their preferences among alternative educational formats. The survey sample will be all psychiatrists in the state of Maryland who are providing direct patient care. Based on survey responses, psychiatrists will be classified by learning style (what methods and resources they are most likely to respond to), readiness to adopt guideline-based practices (following Prochaska and DiClemente's readiness to change model), and clinical interest in schizophrenia. Among those treating or having an interest in schizophrenia, willingness to participate in practice assessments will be determined, as will perceived need for practice tools to overcome barriers to implementation of guideline-based patient care. The findings of this research will be used to design educational intervention trials in Maryland to improve the care of patients with schizophrenia.
