Hsiang Huang1, Jessica L Gören2, Ya-Fen Chan3, Wayne Katon3, Joan Russo3, Diane Hogan4, Jürgen Unützer3. 1. Department of Psychiatry, Cambridge Health Alliance, Cambridge, MA (H.H.). Electronic address: hhuang@cha.harvard.edu. 2. Pharmacy Practice/Clinical Pharmacy/Psychiatry, University of RI/CHA/Harvard, Somerville, MA (J.L.G.). 3. Psychiatry and Behavioral Sciences, University of Washington Medical Center, Seattle, WA (J.R., W.K., Y.-F.C., J.U.). 4. Humana Cares, St. Petersburg, FL (D.H.).
Abstract
OBJECTIVE: The purpose of this study was to examine patterns of pharmacotherapy for beneficiaries in a high-risk Medicare Advantage program who were diagnosed with bipolar disorder. METHODS: This was a cross-sectional study of 2338 Medicare Advantage beneficiaries diagnosed with bipolar disorder. Pharmacotherapy treatment was assessed via receipt of (1) a mood stabilizer or antipsychotic or both (i.e., guideline concordant bipolar care) and (2) unopposed antidepressant (i.e., without prescription of a mood stabilizer or an antipsychotic). Logistic regression was used to examine correlates of bipolar disorder care. RESULTS: Among those younger than 65 years of age (n = 1395), 54% received guideline concordant therapy and 29% received unopposed antidepressant therapy. Among those 65 years and older (n = 943), 40% received guideline concordant therapy and 33% received unopposed antidepressant therapy. CONCLUSION: Overall, about half of beneficiaries in this Medicare Advantage plan received guideline concordant pharmacotherapy for bipolar disorder, while approximately one-third received an unopposed antidepressant prescription. Antipsychotic medications accounted for most of the monotherapy observed. This study identifies opportunities for further improvements in the pharmacotherapy of bipolar disorder in high-risk Medicare patients.
OBJECTIVE: The purpose of this study was to examine patterns of pharmacotherapy for beneficiaries in a high-risk Medicare Advantage program who were diagnosed with bipolar disorder. METHODS: This was a cross-sectional study of 2338 Medicare Advantage beneficiaries diagnosed with bipolar disorder. Pharmacotherapy treatment was assessed via receipt of (1) a mood stabilizer or antipsychotic or both (i.e., guideline concordant bipolar care) and (2) unopposed antidepressant (i.e., without prescription of a mood stabilizer or an antipsychotic). Logistic regression was used to examine correlates of bipolar disorder care. RESULTS: Among those younger than 65 years of age (n = 1395), 54% received guideline concordant therapy and 29% received unopposed antidepressant therapy. Among those 65 years and older (n = 943), 40% received guideline concordant therapy and 33% received unopposed antidepressant therapy. CONCLUSION: Overall, about half of beneficiaries in this Medicare Advantage plan received guideline concordant pharmacotherapy for bipolar disorder, while approximately one-third received an unopposed antidepressant prescription. Antipsychotic medications accounted for most of the monotherapy observed. This study identifies opportunities for further improvements in the pharmacotherapy of bipolar disorder in high-risk Medicare patients.
Authors: Farifteh Firoozmand Duffy; William Narrow; Joyce C West; Laura J Fochtmann; David A Kahn; Trisha Suppes; John M Oldham; John S McIntyre; Ronald W Manderscheid; Paul Sirovatka; Darrel Regier Journal: Psychiatr Q Date: 2005
Authors: Gabriele S Leverich; Lori L Altshuler; Mark A Frye; Trisha Suppes; Susan L McElroy; Paul E Keck; Ralph W Kupka; Kirk D Denicoff; Willem A Nolen; Heinz Grunze; Maria I Martinez; Robert M Post Journal: Am J Psychiatry Date: 2006-02 Impact factor: 18.112
Authors: Hsiang Huang; Joan Russo; Amy M Bauer; Ya-Fen Chan; Wayne Katon; Diane Hogan; Jürgen Unützer Journal: Gen Hosp Psychiatry Date: 2013-04-01 Impact factor: 3.238
Authors: Gregory C Pope; John Kautter; Randall P Ellis; Arlene S Ash; John Z Ayanian; Lisa I Lezzoni; Melvin J Ingber; Jesse M Levy; John Robst Journal: Health Care Financ Rev Date: 2004