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.
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.
UR - https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85100618048&origin=inward
UR - https://www.ncbi.nlm.nih.gov/pubmed/33581465
U2 - 10.1016/j.jad.2020.12.106
DO - 10.1016/j.jad.2020.12.106
M3 - Article
C2 - 33581465
VL - 283
SP - 395
EP - 401
JO - Journal of Affective Disorders
JF - Journal of Affective Disorders
SN - 0165-0327
ER -