|Pharmacotherapy for acute mania and disconcordance with treatment guidelines: bipolar mania pathway survey (BIPAS) in mainland China|
|Wang, Zuowei1,2; Gao, Keming3; Hong, Wu1; Xing, Mengjuan1; Wu, Zhiguo1; Chen, Jun1; Zhang, Chen1; Yuan, Chengmei1; Huang, Jia1; Peng, Daihui1; Wang, Yong1; Lu, Weihong1; Yi, Zhenghui1; Yu, Xin4; Zhao, Jingping5; Fang, Yiru1|
|关键词||Bipolar disorder Mania Pharmacotherapy Treatment Guidelines|
|WOS标题词||Science & Technology|
|关键词[WOS]||PSYCHIATRY WFSBP GUIDELINES ; BIOLOGICAL TREATMENT ; WORLD FEDERATION ; PHARMACOLOGICAL-TREATMENT ; SPECTRUM DISORDER ; CLINICAL-PRACTICE ; PREVALENCE ; SOCIETIES ; CONCORDANCE ; ADHERENCE|
Background: With the recent attention to evidence-based medicine in psychiatry, a number of treatment guidelines for bipolar disorders have been published. This survey investigated prescribing patterns and predictors for guideline disconcordance in the acute treatment of a manic and mixed episode across mainland China.
Methods: The pharmacological treatments of 2828 patients with a recent hypomanic/manic episode or mixed state were examined. Guidelines disconcordance was determined by comparing the medication(s) patients were prescribed with the recommendation(s) in the guidelines of the Canadian Network for Mood and Anxiety Treatments.
Results: The most common pattern of pharmacological treatments for an acute manic or mixed episode was a mood stabilizer plus an atypical antipsychotic (n = 1345, 47.6%), and the rate of guideline-disconcordant treatments was 11.1%. The patients who were treated in general hospitals were more likely to receive guideline-disconcordant treatments than those who were treated in psychiatric hospitals, with an OR of 1.84 (95% CI 1.44-2.36). Similarly, the patients with a mixed episode at study entry were more likely to receive guideline-disconcordant treatments than those with a manic episode, with an OR of 1.69 (95% CI 1.22-2.35). In contrast, the patients with a longer duration of disease (>5 years) were less likely to receive guideline-disconcordant treatments than those with a short duration, with an OR of 0.47 (95% CI 0.36-0.60).
Conclusions: In mainland China, the disconcordance with treatment guidelines for a most recent acute manic or mixed episode was modest under naturalistic conditions. The higher risk for disconcordance in general hospitals than in psychiatric hospitals suggests that special education based on treatment guidelines to practitioners in general hospitals is necessary in order to reduce the risk for disconcordant treatments.
|项目编号||81301159 ; 91232719 ; ZK2012A12 ; XBR2013087 ; 2012BAI01B04 ; OMA-MH 2011-873|
|资助机构||National Natural Science Foundation of China ; Shanghai Key Medicine Specialties Program ; Training Plan for Excellent Academic Leaders of Shanghai Health System ; 12th Five-year Plan of National Key Technologies RD Program ; National Key Clinical Disciplines at Shanghai Mental Health Center|
|作者单位||1.Peking Univ, Inst Mental Hlth, Beijing 100191, Peoples R China|
2.Shanghai Jiao Tong Univ, Sch Med, Shanghai Mental Hlth Ctr, Div Mood Disorders, Shanghai 200030, Peoples R China
3.Hongkou Dist Mental Hlth Ctr Shanghai, Div Mood Disorders, Shanghai 200083, Peoples R China
4.Case Western Reserve Univ, Univ Hosp Case Med Ctr, Mood & Anxiety Clin, Mood Disorders Program,Dept Psychiat,Sch Med, Cleveland, OH 44106 USA
5.Cent S Univ, Xiangya Hosp 2, Mental Hlth Inst, Changsha 410011, Hunan, Peoples R China
|Wang, Zuowei,Gao, Keming,Hong, Wu,et al. Pharmacotherapy for acute mania and disconcordance with treatment guidelines: bipolar mania pathway survey (BIPAS) in mainland China[J]. BMC PSYCHIATRY,2014,14.|
|APA||Wang, Zuowei.,Gao, Keming.,Hong, Wu.,Xing, Mengjuan.,Wu, Zhiguo.,...&Fang, Yiru.(2014).Pharmacotherapy for acute mania and disconcordance with treatment guidelines: bipolar mania pathway survey (BIPAS) in mainland China.BMC PSYCHIATRY,14.|
|MLA||Wang, Zuowei,et al."Pharmacotherapy for acute mania and disconcordance with treatment guidelines: bipolar mania pathway survey (BIPAS) in mainland China".BMC PSYCHIATRY 14(2014).|