Design and implementation of a randomized trial evaluating systematic care for bipolar disorder

Area of Science:

• Psychiatry
• Health Services Research
• Clinical Trial Design

Background:

• Bipolar disorder care often lacks evidence-based practices.
• A randomized trial was designed to address this gap.
• The study focuses on improving care quality and continuity.

Purpose of the Study:

• To evaluate a systematic program aimed at enhancing bipolar disorder treatment.
• To assess patient engagement with intervention components.
• To lay the groundwork for future clinical and cost-effectiveness analyses.

Main Methods:

• A randomized trial identified patients with bipolar disorder from health plan records.
• Participants received either usual care or a multifaceted intervention.
• The intervention included collaborative plans, nurse care management, provider feedback, and psychoeducation.

Main Results:

• 441 patients consented, with 43% experiencing current mood episodes.
• 94% of intervention participants engaged in telephone monitoring.
• 70% of intervention participants attended at least one group session.

Conclusions:

• Two-thirds of patients in a population sample agreed to participate in the trial.
• High adherence was observed for telephone monitoring and group programs.
• The study sets the stage for evaluating the intervention's effectiveness and cost.