Assessing the impact of a consensus conference on long-term therapy for schizophrenia

Objective: Our aim was to assess the impact of six recommendations regardin g drug prescription on the clinical practices of French psychiatrists. The recommendations were part of the conclusions of a consensus conference enti tled "Long-term therapy of schizophrenia" (Paris, January 1994). Methods: The impact of the conference was assessed on the basis of awarenes s of the existence of the conference, knowledge of its conclusions, and act ual changes in clinical practice. We performed: a) a survey of a representa tive sample of 396 psychiatrists 2 years after the conference; and b) an an alysis of changes in drug prescriptions in a cohort of 2,407 patients with schizophrenia under treatment at the time of the conference. Results: Overall, 78% of interviewed psychiatrists were aware of the existe nce of the conference and 70% of its conclusions. Declared prescription pra ctices conformed with conference conclusions about 60% (10%-95%) of the tim e. No difference in practices was noted between psychiatrists who were awar e of the recommendations and those who were not. Single neuroleptic prescri ptions increased in the cohort study in line with the main conference recom mendation. The increase was small, but significant from 51.1% to 56.4%, and mainly concerned patients recently put on treatment. Contrary to recommend ations, prescriptions of anticholinergics plus neuroleptics inexplicably ro se from 48.2% to 54.3%. Conclusion: Small changes in prescription habits occurred in the wake of th e consensus conference, but we cannot really ascribe them to a direct impac t of the conference. Despite the great pains we took in disseminating the c onclusions of the conference as widely as possible, it is clear that a more forceful action plan (e.g., including continuous medical education) is req uired.