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Evaluation of guideline-concordant care for bipolar disorder among privately insured youth

Evans-Lacko, Sara ORCID: 0000-0003-4691-2630, dosReis, Susan, Kastelic, Elizabeth A., Paula, Cristiane S. and Steinwachs, Donald M. (2010) Evaluation of guideline-concordant care for bipolar disorder among privately insured youth. Primary Care Companion for CNS Disorders, 12 (3). e1-e8. ISSN 2155-7772

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Identification Number: 10.4088/PCC.09m00837gry


OBJECTIVE: To describe and quantify the prevalence of treatments and services for youth with bipolar disorder and to assess whether concordance with treatment guidelines is associated with inpatient hospitalization and emergency department visits. METHOD: Insurance claims of 423 privately insured youth (ages 6-18) having prescription drug coverage and diagnosed with bipolar disorder were examined from the 2000-2001 Thomson Medstat MarketScan database, a national (US) dataset. Treatments and services were examined for the 6 months following the index bipolar disorder diagnosis, defined as the first diagnosis after a diagnosis-free period of 6 months. RESULTS: The majority of youth did not receive guideline-concordant care. Only 26% (n = 109) received a mood stabilizer or antipsychotic, as recommended, within 1 month of a bipolar diagnosis. Antidepressant monotherapy, which is contraindicated in therapeutic guidelines, was observed for 33% (n = 140) of youth. Less than 40% of youth received adjunctive psychotherapy. Guideline concordance was statistically significantly related to a lower likelihood of an inpatient hospitalization or an emergency department visit. CONCLUSIONS: Although deviation from guidelines may be warranted in some cases due to individual variation and patient complexity or patient and/or family preferences, these findings suggest that evidence-based guidelines are not followed in clinical practice. Incorporation of guideline-concordant care may increase the likelihood of overall better quality of care and presage better long-term outcomes for youths diagnosed with bipolar disorder.

Item Type: Article
Official URL:
Additional Information: © Copyright 2010 Physicians Postgraduate Press, Inc
Divisions: Personal Social Services Research Unit
Subjects: R Medicine > RC Internal medicine
Date Deposited: 10 Aug 2015 09:56
Last Modified: 16 May 2024 01:11

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