P-175 - Concordance of maintenance treatment patterns for bipolar disorders with current practice guidelines in an outpatient setting - 13/06/12
Résumé |
Introduction |
Wide variations in guideline concordance rates for bipolar disorder have been reported. To the authors’ knowledge, no studies have been carried out in Spain.
Objective |
To evaluate whether maintenance treatment patterns for outpatients with bipolar disorders in usual practice are concordant with evidence-based prescription guidelines.
Methods |
Cross-sectional data are being collected, starting June 2011, from outpatients diagnosed of bipolar I or II disorders attended at a Mental Health Center in Bilbao (Spain). Information about their maintenance treatment is reviewed, and labelled as “concordant” or “non-concordant”. Medication considered concordant with current guidelines1,3 are lithium (serum levels 0,6–1,2mEq/L obtained within the previous 6 months), valproate (serum levels 50–100μg/mL within the previous 6 months), carbamazepine (serum levels 4–12μg/mL within the previous 6 months), quetiapine (≥300mg/d), olanzapine (≥10mg/d), aripiprazole (≥15mg/d) and, in bipolar II, lamotrigine ≥100mg/d. Adjunctive use of other medications is also recorded. To assess concordance when various drugs are combined, at least one of them needs to be within therapeutic dose.
Results |
Hitherto, data from 50 patients have been analyzed (66% females; mean age 52,82±13,35; 68% bipolar I). 60% of them present a concordant treatment; 67,64% in the bipolar I subgroup and 43,75% in the bipolar II. Half of the patients are on antidepressants.
Conclusions |
Despite the still small sample size and need of a multicenter assessment, adherence to guidelines seems suboptimal, mainly respecting bipolar II. Implementing interventions that have proven effective for enhancing evidence-based care and therefore improving outcomes should be considered.
Le texte complet de cet article est disponible en PDF.Vol 27 - N° S1
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