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Comparably high retention and low relapse rates in different subpopulations of bipolar patients in a German non-interventional study
BACKGROUND: Although a range of pharmacotherapeutical options are available for the treatment of bipolar disorder, patient non-adherence to prescribed treatment regimens and early treatment discontinuation remain among the primary obstacles to effective treatment. Therefore, this observational study...
Autores principales: | , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2013
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3724595/ https://www.ncbi.nlm.nih.gov/pubmed/23866017 http://dx.doi.org/10.1186/1471-244X-13-193 |
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author | Kraemer, Susanne Minarzyk, Anette Eppendorfer, Steffen Henneges, Carsten Hundemer, Hans-Peter Wilhelm, Stefan Grunze, Heinz |
author_facet | Kraemer, Susanne Minarzyk, Anette Eppendorfer, Steffen Henneges, Carsten Hundemer, Hans-Peter Wilhelm, Stefan Grunze, Heinz |
author_sort | Kraemer, Susanne |
collection | PubMed |
description | BACKGROUND: Although a range of pharmacotherapeutical options are available for the treatment of bipolar disorder, patient non-adherence to prescribed treatment regimens and early treatment discontinuation remain among the primary obstacles to effective treatment. Therefore, this observational study assessed time on mood stabilizing medication and retention rates in patients with bipolar disorder (BD). METHODS: In an 18-month, prospective, multicenter, non-interventional study conducted in Germany 761 outpatients (≥18 years) with BD and on maintenance therapy were documented. For analysis, patients were stratified by baseline medication: monotherapy olanzapine (OM, N = 186), lithium (LM, N = 152), anticonvulsants (N = 216), other mood stabilizing medication (OMS, N = 44); combination therapy olanzapine/lithium (N = 47), olanzapine/anticonvulsant (N = 68), other combinations (OC, N = 48). Continuation on medication was assessed as retention rates with 95% confidence intervals. Time to discontinuation and relapse-free time were calculated by Kaplan-Meier analysis. A relapse was defined as increase to CGI-BP >3, worsening of CGI-BP by ≥2 points, hospitalization or death related to BD. A Cox regression was calculated for the discontinuation of mood stabilizing therapy (reference: OM). Logistic regression models with stepwise forward selection were used to explore possible predictors of maintenance of treatment and relapse. RESULTS: After 540 days (18 months), the overall retention rate of baseline medication was 87.7%, without notable differences between the cohorts. The overall mean time on mood stabilizing treatment was 444.7 days, with a range of 377.5 (OMS) to 481 (LM) by cohort. 74.0% of all patients were without relapse, with rates between the cohorts ranging from 58.4% (OC) to 80.2% (LM). CONCLUSIONS: Retention rates exceeded controlled trial results in all treatment cohorts, in addition to other explanations possibly reflecting that the physicians were expertly adapting treatment regimens to the individual patient’s disease characteristics and special needs. |
format | Online Article Text |
id | pubmed-3724595 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2013 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-37245952013-07-27 Comparably high retention and low relapse rates in different subpopulations of bipolar patients in a German non-interventional study Kraemer, Susanne Minarzyk, Anette Eppendorfer, Steffen Henneges, Carsten Hundemer, Hans-Peter Wilhelm, Stefan Grunze, Heinz BMC Psychiatry Research Article BACKGROUND: Although a range of pharmacotherapeutical options are available for the treatment of bipolar disorder, patient non-adherence to prescribed treatment regimens and early treatment discontinuation remain among the primary obstacles to effective treatment. Therefore, this observational study assessed time on mood stabilizing medication and retention rates in patients with bipolar disorder (BD). METHODS: In an 18-month, prospective, multicenter, non-interventional study conducted in Germany 761 outpatients (≥18 years) with BD and on maintenance therapy were documented. For analysis, patients were stratified by baseline medication: monotherapy olanzapine (OM, N = 186), lithium (LM, N = 152), anticonvulsants (N = 216), other mood stabilizing medication (OMS, N = 44); combination therapy olanzapine/lithium (N = 47), olanzapine/anticonvulsant (N = 68), other combinations (OC, N = 48). Continuation on medication was assessed as retention rates with 95% confidence intervals. Time to discontinuation and relapse-free time were calculated by Kaplan-Meier analysis. A relapse was defined as increase to CGI-BP >3, worsening of CGI-BP by ≥2 points, hospitalization or death related to BD. A Cox regression was calculated for the discontinuation of mood stabilizing therapy (reference: OM). Logistic regression models with stepwise forward selection were used to explore possible predictors of maintenance of treatment and relapse. RESULTS: After 540 days (18 months), the overall retention rate of baseline medication was 87.7%, without notable differences between the cohorts. The overall mean time on mood stabilizing treatment was 444.7 days, with a range of 377.5 (OMS) to 481 (LM) by cohort. 74.0% of all patients were without relapse, with rates between the cohorts ranging from 58.4% (OC) to 80.2% (LM). CONCLUSIONS: Retention rates exceeded controlled trial results in all treatment cohorts, in addition to other explanations possibly reflecting that the physicians were expertly adapting treatment regimens to the individual patient’s disease characteristics and special needs. BioMed Central 2013-07-17 /pmc/articles/PMC3724595/ /pubmed/23866017 http://dx.doi.org/10.1186/1471-244X-13-193 Text en Copyright © 2013 Kraemer et al.; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/2.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Research Article Kraemer, Susanne Minarzyk, Anette Eppendorfer, Steffen Henneges, Carsten Hundemer, Hans-Peter Wilhelm, Stefan Grunze, Heinz Comparably high retention and low relapse rates in different subpopulations of bipolar patients in a German non-interventional study |
title | Comparably high retention and low relapse rates in different subpopulations of bipolar patients in a German non-interventional study |
title_full | Comparably high retention and low relapse rates in different subpopulations of bipolar patients in a German non-interventional study |
title_fullStr | Comparably high retention and low relapse rates in different subpopulations of bipolar patients in a German non-interventional study |
title_full_unstemmed | Comparably high retention and low relapse rates in different subpopulations of bipolar patients in a German non-interventional study |
title_short | Comparably high retention and low relapse rates in different subpopulations of bipolar patients in a German non-interventional study |
title_sort | comparably high retention and low relapse rates in different subpopulations of bipolar patients in a german non-interventional study |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3724595/ https://www.ncbi.nlm.nih.gov/pubmed/23866017 http://dx.doi.org/10.1186/1471-244X-13-193 |
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