Collaborative Care for Bipolar Disorder: Part II. Impact on Clinical Outcome, Function, and Costs

Bauer, Mark S.; McBride, M.S.N. Linda; Williford, William O.; Glick, Henry A.; Kinosian, Bruce; Altshuler, Lori L.; Beresford, Thomas P.; Kilbourne, M.P.H. Amy M.; Sajatovic, Martha

doi:10.1176/ps.2006.57.7.937

Cited by 249 publications

(108 citation statements)

References 68 publications

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“…It may be that these patients differed systematically in some way from the patients in our study: the study by Bauer and colleagues (14,15) involved veterans and the study by Simon and colleagues (16) involved members of a managed care health organization (HMO). The Department of Veterans Affairs care setting and culture may facilitate higher participation and retention rates in clinical trials, whereas managed care populations are often healthier and less impaired.…”

Section: Discussionmentioning

confidence: 93%

“…It has been suggested that individuals with more severe symptoms or a longer duration of illness may respond less well to psychosocial treatments for bipolar disorder, compared with individuals with illness of more recent onset or those who are euthymic (6,30). Alternatively, there may be factors related to receiving care for bipolar disorder in a community mental health center that impede treatment, that are not found in the Department of Veterans Affairs (14,15) or in staff model HMOs (16). …”

Section: Discussionmentioning

confidence: 99%

“…Interestingly, clinical characteristics usually associated with poor outcome, such as substance abuse, have not been reported to correlate with diminished LGP participation or success. Moreover, collaborative chronic care management models that have been adapted for bipolar disorder and that include LGP have shown significant improvements in clinical outcome (14–17), function (15), and quality of life (15) in long-term, multisite, randomized controlled trials.…”

mentioning

confidence: 99%

“…A randomized controlled, multicomponent intervention study (that included LGP among the multiple components) conducted in a managed care setting did not specifically evaluate medication adherence (16). A randomized, controlled collaborative care model (CCM) study by the Department of Veterans Affairs that included LGP as one of the multiple components and evaluated medication adherence as a secondary outcome did not find a difference between the CCM group and the control group (17), but because the CCM study had several components it was not possible to separate effects of LGP from those of other activities, such as nurse care management (14,15). To the best of our knowledge, there are no previous studies using a controlled methodology that tested LGP as a stand-alone intervention.…”

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confidence: 99%

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A Comparison of the Life Goals Program and Treatment as Usual for Individuals With Bipolar Disorder

Sajatovic¹,

Davies²,

Ganocy³

et al. 2009

Psychiatric Services

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Objective This randomized controlled study of 164 outpatients with bipolar disorder in a community mental health center who received standardized psychoeducation (Life Goals Program [LGP]) or treatment as usual sought to determine whether there were differences between the groups in medication adherence attitudes and behaviors. Methods Patients were randomly assigned to treatment as usual (N=80) or treatment as usual plus LGP (N=84) and were assessed at baseline and at the three-, six-, and 12-month follow-up. Primary outcomes were change in score from baseline on the Drug Attitude Inventory (DAI) and on self-reported treatment adherence behaviors (SRTAB). Results At baseline, there were no significant differences between the two groups. Slightly less than half (N=41, 49%) of the LGP group participated in most or all (four to six) LGP sessions, 14% (N=12) participated in one to three sessions, and 37% (N=31) did not participate in any sessions. At the 12-month follow-up there was improvement among all patients, with no significant differences between the two groups, in DAI scores, SRTAB, symptoms, psychopathology, and functional status. Greater depressive severity at baseline was associated with more negative attitudes toward treatment over time, although this finding was not significant (p=.056). Secondary analysis of persons in the LGP group found that compared with those who did not go to any LGP sessions, those with partial or full participation in LGP sessions had improved attitudes toward medication at the three- and six-month follow-up, but no difference was found between the three LGP subgroups by the 12-month follow-up. Conclusions There were no differences between two groups in treatment attitudes at the 12-month follow-up. Low attendance rates mitigated effects on primary outcomes. Effects of LGP may become lost over time without ongoing intervention, and individuals with depression may have reduced response to LGP.

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Section: Discussionmentioning

confidence: 93%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

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A Comparison of the Life Goals Program and Treatment as Usual for Individuals With Bipolar Disorder

Sajatovic¹,

Davies²,

Ganocy³

et al. 2009

Psychiatric Services

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“…Finally, the importance of collaborative, team‐based care is increasingly recognized in managing BD. APNs, by their training and experience, are well suited to facilitate optimal patient care in collaboration with the other healthcare team members (Bauer et al., 2006; Chung et al., 2007). An especially important role for APNs within primary care lies in the care of the patient, while specialists manage the bipolar illness.…”

Section: Introductionmentioning

confidence: 99%

Diagnosis and treatment of patients with bipolar disorder: A review for advanced practice nurses

McCormick

Murray

McNew

2015

Journal of the American Association of Nurse Practitioners

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Purpose This review article provides an overview of the frequency, burden of illness, diagnosis, and treatment of bipolar disorder (BD) from the perspective of the advanced practice nurses (APNs). Data sources PubMed searches were conducted using the following keywords: “bipolar disorder and primary care,” restricted to dates 2000 to present; “bipolar disorder and nurse practitioner”; and “bipolar disorder and clinical nurse specialist.” Selected articles were relevant to adult outpatient care in the United States, with a prioritization of articles written by APNs or published in nursing journals. Conclusions BD has a substantial lifetime prevalence in the population at 4%. Because the manic or depressive symptoms of BD tend to be severe and recurrent over a patient's lifetime, the condition is associated with significant burden to the individual, caregivers, and society. Clinician awareness that BD may be present increases the likelihood of successful recognition and appropriate treatment. A number of pharmacological and nonpharmacological treatments are available for acute and maintenance treatments, with the prospect of achieving reduced symptom burden and increased functioning for many patients. Implications for practice Awareness of the disease burden, diagnostic issues, and management choices in BD has the potential to enhance outcome in substantial proportions of patients.

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Prevalence, Heritability, and Prospective Risk Factors for Anorexia Nervosa

Bulik

Sullivan

Tozzi

et al. 2006

Arch Gen Psychiatry

490

312

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Collaborative Care for Bipolar Disorder: Part II. Impact on Clinical Outcome, Function, and Costs

Abstract: Collaborative chronic care models can improve some long-term clinical outcomes for bipolar disorder. Functional and quality-of-life benefits also were demonstrated, with most benefits accruing in years 2 and 3.

Cited by 249 publications

References 68 publications

A Comparison of the Life Goals Program and Treatment as Usual for Individuals With Bipolar Disorder

A Comparison of the Life Goals Program and Treatment as Usual for Individuals With Bipolar Disorder

Diagnosis and treatment of patients with bipolar disorder: A review for advanced practice nurses

Prevalence, Heritability, and Prospective Risk Factors for Anorexia Nervosa

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