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Evidence-based Guidelines for Anxiety Disorders: Can They Improve Clinical Outcomes?

Published online by Cambridge University Press:  07 November 2014

David S. Baldwin
David S. Baldwin*
Affiliation:
Dr. Baldwin is reader in psychiatry in the Department of Psychiatry at, Royal South Hants Hospital in Southampton, United Kingdom
*
David S. Baldwin, MB, BS, DM, FRCPsych, University Department of Psychiatry, Royal South Hants Hospital, Southampton, SO14 0YG, UK; Tel: +44-2380-825533; Fax: +44-2380-234243; E-mail: D.S.Baldwin@soton.ac.uk
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Abstract

Evidence-based medicine (EBM) enables clinicians to justify decision making, enhances the quality of medical practice, identifies unanswered research questions, and ensures the efficient practice of medicine. Implementation of evidence-based mental health programs requires education, time, and improved effort by administration, regulatory, and clinical professionals. Essential to these efforts are consistent incentives for change, effective training materials, and clear clinical guidelines. Guidelines exist within the framework of EBM. Good guidelines are simple, specific, and user friendly, focus on key clinical decisions, are based on research evidence, and present evidence and recommendations in a concise and accessible format. Potential limitations of guidelines to improve clinical outcomes in anxiety disorders are the widespread distribution of anxiety symptoms in primary care, health inequalities across patient groups, persistent misconceptions regarding psychotropic drugs, and low confidence in using simple psychological treatments. Clinical guidelines generally specify therapeutic areas covered and not covered, but often there is no mention of cost or cost effectiveness of treatment. Guidelines can inform clinical decision making, but administrators of drug formularies may regard themselves as being primarily responsible for limiting costs and access to certain medications, even if these decisions are at odds with guideline recommendations.

Type
Research Article
Information
CNS Spectrums , Volume 11 , Issue S12 , 2006 , pp. 34 - 39
Copyright
Copyright © Cambridge University Press 2006

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