Education program improves bipolar management in primary care
MedWire News: Primary care physicians who are trained in the diagnosis and management of bipolar disorder are more likely than untrained physicians correctly to identify bipolar subtypes in their patients, say French researchers.
Incorrectly diagnosing bipolar disorder patients as having unipolar major depression is common in primary care, and can lead to treatment resistance, worsening symptoms, and an increased risk for hospitalization and suicide.
Noting that government agencies and industries have recently instituted educational programs for bipolar management in primary care, Ricardo Garay, from Université Paris-Sud, and colleagues surveyed 45 general practitioners attending one such program and 50 untrained general practitioners.
The participating physicians cared for a total of 2837 patients aged ≥15 years with mood disorders, and were assessed at baseline and after completing the Bipolact Educational Program.
Trained physicians demonstrated a significant improvement in their ability to identify patients with bipolar I and II disorder, with the proportion of correct diagnoses increasing from 10.4% to 28.8% and from 20.1% to 45.8%, respectively. There was a corresponding decrease in the proportion of patients diagnosed with nonidentified bipolar disorder, from 64.6% to 19.5%.
By contrast, there was no significant change in the ability of untrained physicians to diagnose bipolar subtypes between baseline and the final analysis.
Trained physicians also showed a significant increase in the number of mood stabilizers prescribed, a change that was not mirrored in the untrained group. However, physicians in both groups significantly decreased the number of prescriptions for antidepressants during the study period, which the authors say suggests some bias in the survey.
The researchers write: "The treatment of bipolar disorder can be complex and specialist involvement is often needed, however, the general practitioner plays a critical role in the early identification and ongoing management of care for bipolar disorder patients."
They add: "These promising results clearly indicate that educational programs can have a profound short-term impact on the management of bipolar disorder in primary care."
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By Liam Davenport