Stahl Online is a one-stop shop, covering everything a mental health professional or teacher will ever need to know about neuropsychopharmacology. Comprehensive and regularly updated, Stahl Online provides full access to the entire current portfolio of books by Dr Stephen M. Stahl.
Stahl Online is a one-stop shop, covering everything a mental health professional or teacher will ever need to know about neuropsychopharmacology. Comprehensive and regularly updated, Stahl Online provides full access to the entire current portfolio of books by Dr Stephen M. Stahl.
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“Measurement-based care” (MBC) refers to the systematic assessment of patients’ symptoms over the course of some observation period in order to glean information about likely treatment effects. The concept grew mainly from the world of clinical trials and US Food and Drug Administration registration studies, where efforts to judge the efficacy of an intervention depended on reliable quantifiable measures to track changes in symptoms or clinical status over time. In this chapter, our interest in MBC pertains mainly to describing the ways in which it can impact hypothesis-testing, decision-making, and outcome-tracking in clinical practice rather than in research settings.
Edited by
Nevena V. Radonjić, State University of New York Upstate Medical University,Thomas L. Schwartz, State University of New York Upstate Medical University,Stephen M. Stahl, University of California, San Diego
More often than not, an initial intervention in psychiatry requires modification. Sometimes sooner than later, the clinician must judge whether a medication dose needs adjustment, an augmentation is warranted, or an outright change should occur when something has been tried and deemed to be unsuccessful. Perhaps a new additional diagnosis comes to light (such as alcohol or substance use disorder) requiring its own treatment. Or an insurmountable medication intolerance develops. Or the originally identified target symptoms worsen, metamorphose, or persist long enough after a previous medication change to warrant a further alteration. Other times, changes to a regimen happen not necessarily because sufficient time has elapsed to deem a change necessary, but because a patient’s (or significant other’s) capacity to tolerate negative affect or other elements of distress become saturated, prompting entreaties or outright demands to “do” something that seems more proactive. In all such instances, there is seldom if ever only one correct approach to iterative pharmacotherapy.
Edited by
Nevena V. Radonjić, State University of New York Upstate Medical University,Thomas L. Schwartz, State University of New York Upstate Medical University,Stephen M. Stahl, University of California, San Diego
