The International Psychopharmacology Algorithm Project
As the resident-in-charge of the Psychopharmacology Clinic at the University of North Carolina at Chapel Hill in 1978 and later as co-founder of the National Psychopharmacology Laboratory, Dr Kenneth Jobson became aware of the salience of clinical questions about the sequencing of medications, especially those about treatment subsequent to failed or inadequate response.
Subsequently a family member’s life was prolonged by a treatment from M D Anderson Cancer hospital using a protocol for previously resistant illness. Using this model, Jobson made a commitment to try to improve medication choice in psychiatry through what became known as the International Psychopharmacology Algorithm Project.
In 1985, Jobson contacted a group of colleagues to share algorithms. The Delphi method -- each participant’s treatment sequences would be submitted, then all shared among the group, minimizing the influence of “expert” opinions -- was used. This “project” was well-received and informative. Eventually the group -- which included faculty from Duke, Emory, Harvard, Stanford and Yale Universities; National Institutes of Mental Health and multiple international sites including the Universities of Vienna and Stellenbosh (South Africa) and from Sendai, Japan -- addressed, one by one, the major Axis I psychiatric illnesses in this way.
In 1992, speaking with longtime friend and colleague Bill Potter, then head of extra-mutual research at NIMH, Jobson learned that there was virtually no interest in funding research about medication choice sequencing (algorithms). Jobson explained that clinicians make those decisions daily and spoke about his informal algorithm project. They agreed that it would be worthwhile to have a national conference to create awareness of the need for psychopharmacology algorithms. So the project was formalized as the International Psychopharmacology Algorithm Project and the first educational conference was held in 1993 at the National Institutes of Mental Health.
The International Psychopharmacology Algorithm Project is a not-for-profit corporation registered in Tennessee. In the main, our projects are made possible by grants from the Dean Foundation, a not-for-profit entity registered in Wisconsin. The Dean Foundation accepts funds designated for use by IPAP from both pharmaceutical companies (including Astra Zeneca, Bristol-Myers Squibb, Eli Lilly, Janssen, Johnson & Johnson, Novartis, Pfizer and Wyeth-Ayerst) and private donors.
Any funds accepted for the use of IPAP must be undesignated, co-mingled and for use only at the discretion of IPAP for its research and education projects.
The current Advisory Group consists of the following members:
Adapted from York St. John College, Website for The Practical Use of Research Methods for Health Professionals, Extra Resources: Models of Appraisal.
I A. Strong Evidence from at least one systematic review of multiple well-designed randomized control trials.
I B. Multiple well designed randomized control trials.
II. Strong Evidence from at least one properly designed randomized controlled trial of appropriate size.
III. Evidence from well-designed trial without randomization, single group pre-post, cohort, time series or matched case-control studies.
IV. Evidence from well-designed non-experimental studies from more than one center or research group.
V. Opinions of respected authorities based on clinical evidence, descriptive studies or reports of expert committees.
Long, AF. (2002) 'Critically appraising research studies' in McSherry R, Simmons M and Abbott P (eds) Evidence-Informed Nursing: A Guide for Clinical Nurses. London: Routledge.