BACKGROUND: The effectiveness of bipolar collaborative chronic care models (B-CCMs) among those with co-occurring substance use, psychiatric, and/or medical conditions has not specifically been assessed. We assessed whether B-CCM effects are equivalent comparing those with and without co-occurring conditions. METHODS: We reanalyzed data from the VA Cooperative Study #430 (n=290), an 11-site randomized controlled trial of the B-CCM compared to usual care. Moderators included common co-occurring conditions observed in patients with bipolar disorder, including substance use disorders (SUD), anxiety, psychosis; medical comorbidities (total number), and cardiovascular disease-related conditions (CVD). Mixed-effects regression models were used to determine interactive effects between moderators and 3-year primary outcomes. RESULTS: Treatment effects were comparable for those with and without co-occurring substance use and psychiatric conditions, although possibly less effective in improving physical quality of life in those with CVD-related conditions (Beta=-6.11;p=0.04). LIMITATIONS: Limitations included multiple comparisons and underpowered analyses of moderator effects. CONCLUSIONS:B-CCM effects were comparable in patients with co-occurring conditions, indicating that the intervention may be generally applied. Specific attention to physical quality of life in those with CVD maybe warranted.
RCT Entities:
BACKGROUND: The effectiveness of bipolar collaborative chronic care models (B-CCMs) among those with co-occurring substance use, psychiatric, and/or medical conditions has not specifically been assessed. We assessed whether B-CCM effects are equivalent comparing those with and without co-occurring conditions. METHODS: We reanalyzed data from the VA Cooperative Study #430 (n=290), an 11-site randomized controlled trial of the B-CCM compared to usual care. Moderators included common co-occurring conditions observed in patients with bipolar disorder, including substance use disorders (SUD), anxiety, psychosis; medical comorbidities (total number), and cardiovascular disease-related conditions (CVD). Mixed-effects regression models were used to determine interactive effects between moderators and 3-year primary outcomes. RESULTS: Treatment effects were comparable for those with and without co-occurring substance use and psychiatric conditions, although possibly less effective in improving physical quality of life in those with CVD-related conditions (Beta=-6.11;p=0.04). LIMITATIONS: Limitations included multiple comparisons and underpowered analyses of moderator effects. CONCLUSIONS: B-CCM effects were comparable in patients with co-occurring conditions, indicating that the intervention may be generally applied. Specific attention to physical quality of life in those with CVD maybe warranted.
Authors: Laura A Bajor; Zongshan Lai; David E Goodrich; Christopher J Miller; Robert B Penfold; Hyungjin Myra Kim; Mark S Bauer; Amy M Kilbourne Journal: J Affect Disord Date: 2012-09-27 Impact factor: 4.839
Authors: Christopher J Miller; Andrew Grogan-Kaylor; Brian E Perron; Amy M Kilbourne; Emily Woltmann; Mark S Bauer Journal: Med Care Date: 2013-10 Impact factor: 2.983
Authors: Alexandra K Gold; Amy T Peters; Michael W Otto; Louisa G Sylvia; Pedro Vieira da Silva Magalhaes; Michael Berk; Darin D Dougherty; David J Miklowitz; Ellen Frank; Andrew A Nierenberg; Thilo Deckersbach Journal: Aust N Z J Psychiatry Date: 2018-07-26 Impact factor: 5.744
Authors: Amy M Kilbourne; Daniel Almirall; Daniel Eisenberg; Jeanette Waxmonsky; David E Goodrich; John C Fortney; JoAnn E Kirchner; Leif I Solberg; Deborah Main; Mark S Bauer; Julia Kyle; Susan A Murphy; Kristina M Nord; Marshall R Thomas Journal: Implement Sci Date: 2014-09-30 Impact factor: 7.327