Evidence map›Paper›PMID 25016355›Full record

ArticlePsychosomatics

Pharmacologic management of bipolar disorder in a Medicare Advantage population.

Hsiang Huang, Jessica L Gören, Ya-Fen Chan, Wayne Katon, Joan Russo, Diane Hogan, Jürgen Unützer

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Psychosomatics. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Article
  2. Review
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Hsiang HuangDepartment of Psychiatry, Cambridge Health Alliance, Cambridge, MA (H.H.). Electronic address: hhuang@cha.harvard.edu.
Jessica L GörenPharmacy Practice/Clinical Pharmacy/Psychiatry, University of RI/CHA/Harvard, Somerville, MA (J.L.G.).
Ya-Fen ChanPsychiatry and Behavioral Sciences, University of Washington Medical Center, Seattle, WA (J.R., W.K., Y.-F.C., J.U.).
Wayne KatonPsychiatry and Behavioral Sciences, University of Washington Medical Center, Seattle, WA (J.R., W.K., Y.-F.C., J.U.).
Joan RussoPsychiatry and Behavioral Sciences, University of Washington Medical Center, Seattle, WA (J.R., W.K., Y.-F.C., J.U.).
Diane HoganHumana Cares, St. Petersburg, FL (D.H.).
Jürgen UnützerPsychiatry and Behavioral Sciences, University of Washington Medical Center, Seattle, WA (J.R., W.K., Y.-F.C., J.U.).

Funding

Psychiatry Primary Care NRSA T-32 AwardT32MH020021 · NIMH · UNIVERSITY OF WASHINGTON · PI JOHN C. FORTNEY, JURGEN UNUTZER · 1998 to 2026
$5.6M
NIMH NIH HHS MH0751590NIMH NIH HHS T32 MH020021NIMH NIH HHS T32 MH20021-14
6 · The paper itself

Abstract

objectiveThe 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.

methodsThis 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.

resultsAmong 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.

conclusionOverall, 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.

Indexed as

Medicare Part CAgedAge FactorsAntidepressive AgentsAntipsychotic AgentsBipolar DisorderCross-Sectional StudiesDrug Therapy, CombinationFemaleGuideline AdherenceHumansMaleMiddle AgedUnited StatesAntidepressive AgentsAntipsychotic Agents

Identifiers

PMID25016355
PMCPMC4201980

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