Measure:

Bipolar Disorder: Providing condition-specific education and information

Summary:

This measure assesses the percentage of patients diagnosed and treated for bipolar disorder who are provided with education and information about their illness and treatment within 12 weeks of initiating treatment.

Clinical Rationale:

The Role of Education in Psychiatric Treatment

• Specific goals of psychiatric treatment for bipolar disorder include providing education to assist the patient in understanding and accepting their illness and to reinforce the patient’s collaborative role in the treatment of this persistent condition (1)
• Patient’s who do not believe or understand that they have a serious illness are less likely to adhere to long-term treatment regimens that can improve their health status (1)
• Patients and families can also benefit from an understanding of the role of psychosocial stressors and other disruptions in precipitating or exacerbating mood episodes
• Patients should know how to recognize and report early signs and symptoms of relapse; this has been shown to improve relapse time periods, social functioning, and employment (2)

Providing Education

• Clinicians should provide information about treatment options and costs involving specific medications, including dosing strategies, side effect profiles, drug interactions, potential toxicity and other safety considerations (3)
• Over a period of time, health care professionals should gradually introduce facts about the illness as the patient’s ability to accept and retain this information will vary over time (1)
• Printed material can assist in reinforcing education provided by the health care provider (1)

Denominator Population:

Patients diagnosed and treated for bipolar disorder

Data Sources:

• Administrative data
• Medical Record

Numerator Population:

Patients who receive education/information about bipolar disorder within 12 weeks of initiating treatment

Data Source:

• Medical Record

Initial Case-finding Guidance:

Patients with a diagnosis involving bipolar disorder
ICD9CM or DSM IV TR: 296.0x; 296.1x; 296.4x; 296.5x; 296.6x; 296.7; 296.80-82; 296.89; or 301.13

STABLE Resource Toolkit:

The STABLE National Coordinating Council recommends that durable educational materials (pamphlets; books; video resources) be provided to reinforce the educational information and message.

The following educational resource material is available in the corresponding section of the STABLE Resource Toolkit.

• Listings of national patient advocacy and support organizations with links to their websites and recommendations about educational materials that these organizations offer
• A STABLE Project developed Mood Chart:  A patient self-monitoring and reporting tool

References:

1. Practice Guideline for the Treatment of Patients with Bipolar Disorder (2002 Revision);  American Psychiatric Association; Am J Psychiatry 159:4, April 2002 Supplement
2. Yatham LN, Kennedy SH, et al.; Canadian Network for Mood and Anxiety Treatments (CANMAT) guidelines for the management of patients with bipolar disorder: consensus and controversies, Bipolar Disorders 2005: 7(Suppl. 3): 5-69
3. Suppes T, Dennehy E, Hirschfeld R, Altshuler L, Bowden, Calabrese J, Ketter T, Sachs G, Swann A, The Texas Implementation of Medication Algorithms: Update to the Algorithms for Treatment of Bipolar I Disorder, J Clin Psychiatry 2005; 66:870-886