Pharmacological management of acute mania – does current prescribing practice reflect treatment guidelines?

Streeruwitz, Anna; Barnes, Thomas R. E.; Fehler, J; Ohlsen, Ruth; Curtis, Vivienne

doi:10.1177/0269881107067896

Cited by 3 publications

(3 citation statements)

References 13 publications

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“…Most studies using administrative data to assess guideline adherence focused on one single disorder, mainly depression, and focussed on pharmacotherapy with indicators like prescription of pharmacotherapy, adequate dosage of pharmacotherapy and number and frequency of visits. Unfortunately, contrary to many other databases, described the literature our database did not provide information on the (minimum) dosage of pharmacotherapy [1–18,32–36,42–52]. In our study, adequate duration of pharmacotherapy treatment was found in almost 94% of the cases, which is much higher than that of around 50% found in most other studies using administrative data [3,31,33,34].…”

Section: Discussioncontrasting

confidence: 83%

“…Unfortunately, contrary to many other databases, described the literature our database did not provide information on the (minimum) dosage of pharmacotherapy [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][32][33][34][35][36][42][43][44][45][46][47][48][49][50][51][52]. In our study, adequate duration of pharmacotherapy treatment was found in almost 94% of the cases, which is much higher than that of around 50% found in most other studies using administrative data [3,31,33,34].…”

Section: Discussionmentioning

confidence: 63%

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Assessing adherence to guidelines with administrative data in psychiatric outpatients

Fenema

Giltay

Noorden

et al. 2015

Evaluation Clinical Practice

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Rationale, aims and objectives To assess (feasibility) of adherence to treatment guidelines among outpatients with common mental disorders in a routine Dutch clinical outpatient setting for common mental disorders using administrative data. Methods In a retrospective cohort study, we analysed routinely collected administrative data of 5346 patients, treated for mood, anxiety or somatoform disorders with pharmacotherapy, psychotherapy or a combination of both. Available administrative data allowed assessment of guideline adherence with a disorder-independent set of five quality indicators, assessing psychotherapy, pharmacotherapy, a combination of both and routine outcome measurements (ROM) during diagnostic and therapeutic phases. Associations between the socio-demographic variables age, gender, clinical diagnosis and treatment type on the one hand and non-adherence to guidelines were tested using logistic regression analysis. Results Patients were aged 39.5 years (SD 13.0) on average. The majority of patients were treated with a combination of pharmacotherapy and psychotherapy (50.1%), followed by psychotherapy (44.2%) and pharmacotherapy (5.6%). The majority of patients were suffering from a mood disorder (50.0%), followed by anxiety (43.9%) and somatoform disorders (6.1%). A diagnosis of anxiety or somatoform disorder was associated with higher odds of suboptimal duration [odds ratio (OR): 1.55 and 1.82[ and suboptimal frequency of psychotherapeutic treatment (OR of 0.89 and 0.63), and absence of ROM in the diagnostic phase (ORs 1.31 and 1.36, respectively) compared with depressive disorders. No ROM in the diagnostic phase was also predicted for by increasing age (ORs for the age categories of 56 and older of 1.48). Conclusions In this proof of principal study, we were able to assess some key indicators assessing adherence to clinical guidelines by using administrative data. Also, we could identify predictors of adherence with simple parameters available in every administrative data. Administrative data could help to monitor and aid guideline adherence in routine care, although quality may vary between settings.

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Section: Discussioncontrasting

confidence: 83%

Section: Discussionmentioning

confidence: 63%

Assessing adherence to guidelines with administrative data in psychiatric outpatients

Fenema

Giltay

Noorden

et al. 2015

Evaluation Clinical Practice

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“…So far, numerous studies have been conducted to investigate the adherence of psychiatrists to the PGs in different bipolar phases in the inpatient and outpatient settings (1,(10)(11)(12)(13)(14)(15), and the adherence rate has been found to vary between 27 and 83% (8). The inconsistency observed in the results from these studies has been due to the adoption of different measurement methods.…”

Section: Introductionmentioning

confidence: 99%

A Medication Assessment Tool to Evaluate Prescribers’ Adherence to Practice Guidelines in Bipolar Disorder: Development and Psychometric Properties

Yousefi Mazhin,

Akbari,

Sharif Nia

et al. 2023

Iran J Psychiatry Behav Sci

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Background: In the last decades, bipolar disorder treatments have undergone a gradual shift away from relying on clinical expertise to adopting evidence-based practice guidelines and expert consensus, leading to an improvement in medical care safety, patient performance, and quality of life. Nonetheless, suboptimal prescribing has remained an issue, and there is an excellent opportunity for improving the care standards to reduce symptoms’ recurrence, frequent hospitalizations, and costs. Objectives: This study aimed to develop and validate a medication assessment tool for evaluating prescribers’ adherence to pharmacotherapy recommendations outlined in practice guidelines during the acute phase of bipolar disorder in Iran (MATAPBD). Methods: This mixed-method study was conducted from August 2021 to May 2022. A 54-item pool was developed based on the results from the literature review and research group discussion. The validity (i.e., face, content, and construct) and reliability (i.e., stability and internal consistency) of the tool were evaluated. Results: Four items were rewritten in qualitative content validity. Then, eleven and five items were excluded from the scale in terms of having low content validity ratios and corrected item-total correlation, respectively. The construct validity of the MATAPBD was assessed by adopting the maximum-likelihood exploratory factor analysis method and Promax rotation. The number of latent factors was calculated by performing Horn’s parallel analysis. In exploratory factor analysis, the remaining 17 items were categorized into four factors which explained 57.97% of the total extracted variance. Cronbach’s alpha and McDonald’s omega of all factors were > 0.7, and the intraclass correlation coefficient was 0.914 revealing the strong reliability of MATAPBD. Conclusions: The MATAPBD had good psychometric properties and may have been a valuable tool to evaluate prescribers’ adherence to practice guideline recommendations during the acute phase of bipolar disorder.

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The Role of Polypharmacy in Bipolar Disorder Treatment Guidelines

Grunze

2012

Polypharmacy in Psychiatry Practice, Volume II

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Pharmacological management of acute mania – does current prescribing practice reflect treatment guidelines?

Cited by 3 publications

References 13 publications

Assessing adherence to guidelines with administrative data in psychiatric outpatients

Assessing adherence to guidelines with administrative data in psychiatric outpatients

A Medication Assessment Tool to Evaluate Prescribers’ Adherence to Practice Guidelines in Bipolar Disorder: Development and Psychometric Properties

The Role of Polypharmacy in Bipolar Disorder Treatment Guidelines

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