Complexity and continuity of treatments among privately-insured youth diagnosed with bipolar disorder

Evans-Lacko, Sara ORCID: 0000-0003-4691-2630, Riley, Anne W. and dosReis, Susan (2010) Complexity and continuity of treatments among privately-insured youth diagnosed with bipolar disorder. Frontiers in Psychiatry, 1 (144). ISSN 1664-0640

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Abstract

Objectives: To examine longitudinal patterns of complexity, continuity, and initiation of treatment for youth diagnosed with bipolar disorder. Additionally, we explore bipolar diagnosis stability and its relationship to observed treatment patterns. Methods: A cohort of 426 privately insured youth (ages 6–18) diagnosed with bipolar disorder was identified from the 2000–2001 Thomson/Medstat-MarketScan® database. Medication complexity was defined as number of different psychotropic medication classes dispensed during a 6-month period following a new treatment episode of bipolar disorder. Treatment continuity was examined over a 6-month follow-up period, specifically focusing on mood stabilizing medications and antidepressant monotherapy. Predictors of complexity and continuity were investigated. Results: Fifty-five percent of youth received more than one and 25% received three or more different types of psychotropic medication classes during follow-up. This was contrasted with several youth having no prescription fills (21%) and 31% discontinuing mood stabilizing medication. Youth with a stable bipolar diagnosis were more likely to have continuity of mood stabilizing prescriptions (OR: 4.05), but also greater psychotropic medication complexity. Age, health status/comorbidity, and being in a managed care plan were also related to complexity and continuity of psychotropic medication class regimens. Conclusions: More evidence is needed on the causal patterns leading to increased psychotropic medication complexity and continuity and how diagnosis of bipolar disorder may drive treatment patterns.

Item Type:	Article
Official URL:	http://journal.frontiersin.org/journal/psychiatry#
Additional Information:	© 2010 The Authors
Divisions:	Care Policy and Evaluation Centre
Subjects:	R Medicine > RC Internal medicine
Date Deposited:	10 Aug 2015 08:26
Last Modified:	13 Sep 2024 22:59
Projects:	T32 MH 19545
Funders:	National Institute for Mental Health (NIMH)
URI:	http://eprints.lse.ac.uk/id/eprint/63035

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