Biomedical subjects

Christine Boemer

Publications and source records attributed to Christine Boemer.

3 recordsLinked to original sources

PubMed2005

A psychoeducational program for children with ADHD or depression and their families: results from the CMAP feasibility study.

For children and adolescents with behavioral and emotional disorders and their families, education about their disorders and the treatments is an essential component of a comprehensive approach to their care. Education can encourage active participation in treatment, enhance adherence to treatment regimens, and provide patients and families with important coping skills. Thus, the Children's Medication Algorithm Project (CMAP) incorporated a psychoeducational program into the medication algorithm created to improve treatment of children with ADHD and/or depression in the Texas public mental health sector. This article describes the process by which a comprehensive educational program was developed in partnership with parents and advocates. The final program is described, as well as a pilot study to examine the feasibility of implementation in four community clinics.

Adaptation, Psychological↗

PubMed2004

A feasibility study of the childhood depression medication algorithm: the Texas Children's Medication Algorithm Project (CMAP).

OBJECTIVE: To evaluate the feasibility and impact on clinical response and function associated with the use of an algorithm-driven disease management program (ALGO) for children and adolescents treated for depression with or without attention-deficit/hyperactivity disorder (ADHD) in community mental health centers. METHOD: Interventions included (1). medication algorithms, (2). clinical and technical support for the physician, (3). uniform chart documentation of outcomes, and (4). a patient/family psychoeducation program. Children eligible for entry into the study were referred to the child psychiatrist for initiation or change in medicine. Outcomes of treatment with the ALGO for up to 4 months are presented. Measures of change included clinical symptoms, functioning, and global improvement (Clinical Global Impression Scale). A historical chart cohort from the same clinics was used as a quasi-control. RESULTS: Thirty-nine individuals (depression = 24; comorbid depression with ADHD = 15) were enrolled for treatment with ALGO. One hundred fourteen children were in the control cohort (74 depressed, 40 comorbid). For the ALGO groups, Children's Depression Rating Scale-Revised depression severity scores decreased from 48.2 to 32.5 and Child Adolescent Functioning Assessment Scale function scores improved from 70.3 to 40.9 (all p < or =.0005). Clinical Global Impression Scale severity scores decreased from 5.7 to 3.7 in ALGO compared to only 5.8 to 4.8 in the control (p <.003). CONCLUSIONS: There was clear improvement in clinical symptoms, functioning, and global response with ALGO treatment. The magnitude of the improvement was greater in children and adolescents treated with the ALGO program compared with a historical cohort. These data support the need for controlled studies in larger populations examining the effects of algorithm-driven disease management programs on the clinical outcomes of children with mental illness.

Adolescent↗

PubMed2003

A feasibility study of the children's medication algorithm project (CMAP) algorithm for the treatment of ADHD.

OBJECTIVE: To determine whether an algorithm for the treatment of attention-deficit/hyperactivity disorder (ADHD) can be implemented in a community mental health center. METHOD: Fifty child and adolescent patients at Texas community mental health centers who met criteria for ADHD were treated according to an algorithm-based disease management program for ADHD. Psychiatrists were trained in the use of the algorithm, and each subject underwent a baseline assessment consisting of a structured interview and standardized rating scales. Subjects were monitored for 4 months. At the end of treatment, the psychiatrists completed the Clinical Global Impression Scale (CGI) and the baseline rating scales were repeated. The primary variables of interest were psychiatrist and family adherence to the algorithm. To examine impact on treatment outcome, the CGI of the algorithm subjects was compared with CGIs based on chart reviews of 118 historical controls. RESULTS: Psychiatrists implemented the major aspects of the algorithm, but the detailed tactics of the algorithm (use of fixed titration of stimulants) were less well adhered to. CONCLUSIONS: An algorithm for the treatment of ADHD can be implemented in a community mental health center.

Adolescent↗