TY - JOUR
T1 - Guideline concordance and outcome in long-term naturalistic treatment of bipolar disorder - a one-year longitudinal study using latent change models
AU - Renes, Joannes W.
AU - Maciejewski, Dominique F.
AU - Regeer, Eline J.
AU - Hoogendoorn, Adriaan W.
AU - Nolen, Willem A.
AU - Kupka, Ralph W.
N1 - Funding Information: R.W. Kupka received an unrestricted research grant for this study by AstraZeneca . Funding Information: J.W. Renes and E.J. Regeer received speaker's fees from AstraZeneca, Bristol-Myers Squibb, and Ely Lilly. A. W. Hoogendoorn, and D.F. Maciejewski report no potential conflicts of interest. W.A. Nolen has received grants from the Netherlands Organisation for Health Research and Development, the European Union; has received honoraria/speaker's fees from Lundbeck and Aristo Pharma and has served as consultant for Daleco Pharma. R.W. Kupka received speaker's fees for lectures on symposia sponsored by AstraZeneca, Bristol-Myers Squibb, Lundbeck, Sanofi, and Janssen. W.A. Nolen and R.W. Kupka were members and chairs of Dutch bipolar disorder guideline committees in 2008 and 2015. Publisher Copyright: © 2020 Copyright: Copyright 2021 Elsevier B.V., All rights reserved.
PY - 2021/3/15
Y1 - 2021/3/15
N2 - Background: Only few studies investigated the relation between concordance with treatment guidelines and treatment outcome in everyday treatment of bipolar disorder (BD). Prospective studies are scarce. Methods: A nationwide, naturalistic, prospective study on the relation between guideline concordance and treatment outcome in the long-term outpatient treatment of patients with BD. Participants completed a survey on treatments received and various outcome measures at baseline and after one year. Results: Of 839 patients who completed the baseline survey, 615 (73.3%) also completed the follow-up survey. Consistent with our a priori hypothesis, cross-sectional analyses at baseline showed correlations between guideline concordance with quality of life (r =. 17, p < .001), treatment satisfaction (r =. 17, p <.001), and impaired functioning (r = -.10, p = .04). At follow-up, guideline concordance was correlated with severity of illness (r = -.10, p = .05), quality of life (r =. 18, p < .001), and treatment satisfaction (r =. 15, p < .001). Concerning three additional hypotheses on longitudinal relations between concordance and outcome measures, only a positive relation was found between change in guideline concordance and change in quality of life. Limitations: Selection bias may have occurred by inclusion of patients with neither a very severe nor a very mild course of illness. Conclusions: Although guideline concordance was high throughout the study, change in guideline concordance was positively associated with change in quality of life, suggesting that especially in long-term treatment, continuous efforts to optimize ongoing treatment is essential.
AB - Background: Only few studies investigated the relation between concordance with treatment guidelines and treatment outcome in everyday treatment of bipolar disorder (BD). Prospective studies are scarce. Methods: A nationwide, naturalistic, prospective study on the relation between guideline concordance and treatment outcome in the long-term outpatient treatment of patients with BD. Participants completed a survey on treatments received and various outcome measures at baseline and after one year. Results: Of 839 patients who completed the baseline survey, 615 (73.3%) also completed the follow-up survey. Consistent with our a priori hypothesis, cross-sectional analyses at baseline showed correlations between guideline concordance with quality of life (r =. 17, p < .001), treatment satisfaction (r =. 17, p <.001), and impaired functioning (r = -.10, p = .04). At follow-up, guideline concordance was correlated with severity of illness (r = -.10, p = .05), quality of life (r =. 18, p < .001), and treatment satisfaction (r =. 15, p < .001). Concerning three additional hypotheses on longitudinal relations between concordance and outcome measures, only a positive relation was found between change in guideline concordance and change in quality of life. Limitations: Selection bias may have occurred by inclusion of patients with neither a very severe nor a very mild course of illness. Conclusions: Although guideline concordance was high throughout the study, change in guideline concordance was positively associated with change in quality of life, suggesting that especially in long-term treatment, continuous efforts to optimize ongoing treatment is essential.
KW - Bipolar
KW - Concordance
KW - Guideline
KW - Outcome
UR - http://www.scopus.com/inward/record.url?scp=85100618048&partnerID=8YFLogxK
U2 - https://doi.org/10.1016/j.jad.2020.12.106
DO - https://doi.org/10.1016/j.jad.2020.12.106
M3 - Article
C2 - 33581465
SN - 0165-0327
VL - 283
SP - 395
EP - 401
JO - Journal of affective disorders
JF - Journal of affective disorders
ER -