Jerome Levine, MD, Leslie Citrome, MD, Ari Jaffe, MD and Jim Robinson, M.Ed., Program Participants

In order to conduct research studies on medication utilization and medication effectiveness (outcomes) on a statewide basis, NKI has created an Integrated Research Database (IRDB). This is a large, integrated database that contains psychiatric and medication data on all inpatients treated by the New York State Office of Mental Health (OMH). Information is extracted from multiple, operational, information systems and transferred to NKI where it is reorganized, reduced, simplified and restructured into a single, longitudinal statewide database. Data is updated on a monthly basis, with more frequent updates possible for special purpose studies. The IRDB has been specifically designed to facilitate large scale research studies.

The IRDB is organized on a patient specific basis. That is, admission, demographic, diagnostic, medication and discharge information is integrated for each individual patient. Patients are uniquely identified within the database allowing specific patients and/or cohorts of patients to be tracked and re-admissions to be monitored both within a particular center or across all centers (i.e., on a statewide basis). Detailed medication histories are also maintained for each patient. Thus, new medication starts, switches to or from a specific medication, and medication discontinuation information is available.

On a continuing basis, since 1994, quarterly studies of antipsychotic medication utilization have been conducted along with individual studies which have resulted in the following publications:

Jaffe, A.B. and Levine, J. Antipsychotic Medication Coprescribing in a Large State Hospital System. Pharmacoepidemiology and Drug Safety, 12(1): 41-48, 2003.

Jaffe, A.B. and Levine, J. Efficacy and Effectiveness of First- and Second-Generation Antipsychotics in Schizophrenia. Journal Clinical Psychiatry, 64[suppl 17] :3-6, 2003

Citrome L., Levine J., Allingham B. Changes in use of valproate and other mood stabilizers for patients with schizophrenia from 1994 to 1998. Psychiatric Services 51(5):634-638, 2000.

Citrome L., Jaffe A., Levine J. Datapoints - Use of mood stabilizers among patients with schizophrenia, 1994-2001, Psychiatric Services 53(10):1212, 2002.

Javitt, D.C., Cienfuegos, A., Miniati, M., Silipo, G., Levine, J., Allingham, B.H., and Robinson, J. A Naturalistic Study of Risperidone Treatment Outcome Using Prognosis-Adjusted Discharge Rates in New York State Inpatients. J Clin Psychiatry , 63(7):585-590, 2002.

Levine J. and Jaffe, A. Antipsychotic Medication Utilization in a State Hospital System 1994-2000. Chapter 15 pages 199-208, In Mental Health, United States, 2002, Manderscheid R.W., Henderson, M.J. (eds.) U.S. Department of Health and Human Services Substance Abuse and Mental Health Services Administration Center for Mental health Services: Rockville, MD, 2004.

For further information, contact Jerome Levine at