Collaborative care for bipolar disorder, Part II: impact on clinical outcome, function, and costs.
Open accessAbstract
OBJECTIVE: The study addressed whether a collaborative model for chronic care, described in part I (this issue), improves outcome for bipolar disorder. METHODS: The intervention was designed to improve outcome by enhancing patient self-management skills with group psychoeducation; providing clinician decision support with simplified practice guidelines; and improving access to care, continuity of care, and information flow via nurse care coordinators. In an effectiveness design veterans with bipolar disorder at 11 Veterans Affairs hospitals were randomly assigned to three years of care in the intervention or continued usual care. Blinded clinical and functional measures were obtained every eight weeks. Intention-to-treat analysis (N=306) with mixed-effects models addressed the hypothesis that improvements would accrue over three years, consistent with social learning theory. RESULTS: The intervention significantly reduced weeks in affective episode, primarily mania. Broad-based improvements were demonstrated in social role function, mental quality of life, and treatment satisfaction. Reductions in mean manic and depressive symptoms were not significant. The intervention was cost-neutral while achieving a net reduction of 6.2 weeks in affective episode. CONCLUSIONS: 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.
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Miziou, S., Tsitsipa, E., Moysidou, S., Karavelas, V., Dimelis, D., Polyzoidou, V., & Fountoulakis, K. N. (2015) · Annals of General Psychiatry · doi:10.1186/s12991-015-0057-z · Cited by 102 · see citing works
Pomerantz, A. S., Corson, J. A., & Detzer, M. J. (2009) · Journal of Clinical Psychology in Medical Settings · doi:10.1007/s10880-009-9147-x · Cited by 76 · see citing works
Psychotherapy for bipolar II disorder: The role of interpersonal and social rhythm therapy.
Swartz, H. A., Levenson, J. C., & Frank, E. (2012) · Professional Psychology: Research and Practice · doi:10.1037/a0027671 · Cited by 62 · see citing works
Smith, S. N., Almirall, D., Prenovost, K., Liebrecht, C., Kyle, J., Eisenberg, D., Bauer, M. S., & Kilbourne, A. M. (2019) · Medical Care · doi:10.1097/mlr.0000000000001138 · Cited by 40 · see citing works
Self-citationSystemic challenges in bipolar disorder management: A patient‐centered approach
Nestsiarovich, A., Hurwitz, N. G., Nelson, S. J., Crisanti, A. S., Kerner, B., Kuntz, M. J., Smith, A. N., Volesky, E., Schroeter, Q. L., DeShaw, J. L., et al. (2017) · Bipolar Disorders · doi:10.1111/bdi.12547 · Cited by 30 · see citing works
Combined treatment: impact of optimal psychotherapy and medication in bipolar disorder
Parikh, S. V., Hawke, L. D., Velyvis, V., Zaretsky, A., Beaulieu, S., Patelis‐Siotis, I., MacQueen, G., Young, L. T., Yatham, L. N., & Cervantes, P. (2015) · Bipolar Disorders · doi:10.1111/bdi.12233 · Cited by 31 · see citing works
Severe mental illness and mortality of hospitalized ACS patients in the VHA
Plomondon, M. E., Ho, P. M., Wang, L., Greiner, G. T., Shore, J. H., Sakai, J. T., Fihn, S. D., & Rumsfeld, J. S. (2007) · BMC Health Services Research · doi:10.1186/1472-6963-7-146 · Cited by 26 · see citing works
Psychoeducation for Bipolar Mood Disorder
Fayyazi Bordbar, M. R., & Faridhosseini, F. (2012) · Clinical, Research and Treatment Approaches to Affective Disorders · doi:10.5772/31698 · Cited by 21 · see citing works
- Authors
- Bauer, M. S., McBride, L., Williford, W. O., Glick, H., Kinosian, B., Altshuler, L., Beresford, T., Kilbourne, A. M., & Sajatovic, M.
- Affiliations
- Providence VA Medical Center (US)
- University of Maryland, College Park (US)
- University of Pennsylvania (US)
- University of California, Los Angeles (US)
- University of Colorado Denver (US)
- Venue
- Psychiatric Services
- Published
- 2006-07
- Volume
- 57
- Issue
- 7
- Pages
- 937-945
- ISSN
- 0022-1597 (ISSN-L)
- 1075-2730
- 1557-9700
- OpenAlex
- W2049050007
- Semantic Scholar
- 087eb5facd387ea4819c1b0e9989407f4cb64870
- Cited by
- 312
- References
- 75
- Citations by year
- 2026: 4 · 2025: 5 · 2024: 9 · 2023: 1 · 2022: 12 · 2021: 14 · 2020: 14 · 2019: 25 · 2018: 15 · 2017: 19 · 2016: 12 · 2015: 19 · 2014: 22 · 2013: 17 · 2012: 24
- FWCI
- 12.53
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- other-oa
- Locations
- Psychiatric Services (publishedVersion, other-oa)
- PubMed (publishedVersion)
- Digital Commons - East Tennessee State University (East Tennessee State University) (submittedVersion)
- Funders
- U.S. Department of Veterans Affairs
- National Institute of Mental Health
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Bipolar Disorder and Treatment
- Social Sciences › Psychology › Clinical Psychology › Psychiatric care and mental health services
- Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
- Keywords
- bipolar disorder, collaborative care, Chronic Care Model, veterans, group psychoeducation, clinician decision support, clinical guidelines, self-management skills, mania, quality of life, treatment satisfaction, continuity of care, social learning theory
- MeSH terms
- Adult, Bipolar Disorder, Chronic Disease, Combined Modality Therapy, Community Mental Health Services, Continuity of Patient Care, Cooperative Behavior, Cost-Benefit Analysis, Female, Follow-Up Studies, Health Plan Implementation, Health Services Accessibility, Hospitals, Veterans, Humans, Male, Middle Aged, Patient Care Team, Patient Education as Topic, Self Care, United States, Veterans, Outcome Assessment, Health Care, Practice Guidelines as Topic, Delivery of Health Care, Integrated, Case Management
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