The Antipsychotic Medication Management Fidelity Scale: Psychometric properties
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ORIGINAL PAPER
The Antipsychotic Medication Management Fidelity Scale: Psychometric properties Torleif Ruud1,2 · Karin Drivenes3,4 · Robert E. Drake5 · Vegard Øksendal Haaland6,7 · Matthew Landers8 · Bjørn Stensrud9,10 · Kristin S. Heiervang1 · Lars Tanum1,11 · Gary R. Bond5
© The Author(s) 2020
Abstract The paper describes the Antipsychotic Medication Management Fidelity Scale and its psychometric properties, including interrater reliability, frequency distribution, sensitivity to change and feasibility. Fidelity assessors conducted fidelity reviews four times over 18 months at eight sites receiving implementation support for evidence-based antipsychotic medication management. Data analyses shows good to fair interrater reliability, adequate sensitivity to change over time and good feasibility. At 18 months, item ratings varied from poor to full fidelity on most items. Use of the scale can assess fidelity to evidence-based guidelines for antipsychotic medication management and guide efforts to improve practice. Further research should improve and better calibrate some items, and improve the procedures for access to information. Trial registration: ClinicalTrials.gov Identifier: NCT03271242. Keywords Psychosis · Antipsychotic medication · Implementation · Evidence-based practice · Fidelity scale
Introduction Clinical trials and systematic reviews have established the core components of evidence-based antipsychotic medication management. Clinical guidelines make this researchbased knowledge more available for clinicians. However, implementation of clinical guidelines remains fraught with difficulties (Barbui et al. 2014), often because guidelines lack sufficient details and measures. Electronic supplementary material The online version of this article (https://doi.org/10.1007/s10488-020-01018-1) contains supplementary material, which is available to authorized users. * Torleif Ruud [email protected] 1
Division of Mental Health Services, Akershus University Hospital, Lørenskog, Norway
Institute of Clincial Medicine, University of Oslo, Oslo, Norway
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5
Antipsychotic medication management requires an operational model such as a fidelity scale. Fidelity scales measure evidence-based practices and provide objective data to a clinical team or program regarding implementation of key components of the model (Bond and Drake 2019). Fidelity scales also facilitate research to identify, measure, and improve components and effects. We therefore developed and tested a fidelity scale for antipsychotic medication management for use in treatment of persons with psychoses within the diagnostic groups F20–F29 in ICD-10, with schizophrenia as the major group often needing long term antipsychotic medication. 6
Sørlandet Hospital, Kristiansand, Norway
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Clinical Neuroscience Research Group, Department of Psychology, The Faculty of Social Sciences, University of Oslo, Oslo, Norway
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Duke University, Durham, NC, USA
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Division of Mental Health, Innlandet Hospital Trust, Bru
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