El efecto de las estrategias de aplicación de directrices sobre los resultados acatisia en la esquizofrenia

Background: The purpose of this study was to examine the effect of a conceptually driven, multicomponent strategy for implementing guidelines to improve akathisia in schizophrenia. Methods: Patients included in the study were recruited from 6 Veterans Affairs Medical Centers (VAMCs) that were split into geographically matched pairs with 3 VAMCs receiving basic education and 3 receiving enhanced intervention to promote guideline-concordant treatment and patient adherence. Results: Of 293 patients with baseline and 6-month follow-up Barnes Akathisia Rating Scale (BARS) scores, results of both non-parametric and parametric repeated measures ANOVA showed several significant site-pair intervention effects, though the patterns were not consistent across the site-pairs. Logistic regression results controlling for baseline akathisia diagnosis and for patient covariates showed varying effects of the intervention among site-pairs as well. Exploratory results for differences in akathisia in those on novel versus conventional antipsychotics are also presented. Conclusions: Akathisia tended to improve over time, but the enhanced guideline-implementation strategy did not consistently result in lower prevalence and severity of akathisia at all sites, apparently due to considerable differences in patient or site characteristics.