Recommendation ID
CG185/4
Question
A specialised collaborative care service for people with bipolar disorder:- What is the clinical and cost effectiveness of a specialised collaborative care service for people admitted to hospital with bipolar disorder compared with usual treatment delivered by generic care services?
Any explanatory notes
(if applicable)
There is moderate-quality evidence of the effectiveness of a specialised collaborative care service compared with usual treatment in reducing hospitalisation in 2 studies (from Denmark and the USA). There is no overall evidence of an effect on relapse or other outcomes. An economic analysis from 1 study showed that better clinical outcomes were achieved at two-thirds of the overall cost of usual treatment. If similar results were obtained in England, then better care for a substantially reduced cost might be achieved. A 2-arm multicentre RCT of a specialist collaborative care service for people admitted to hospital with bipolar disorder compared with usual treatment, with follow-up of at least 2 years, is needed. Community alternatives to hospitalisation should be included. The specialist intervention should be based on collaborative care principles, including group or other psychoeducation to promote self-management, care coordination and algorithm-derived psychotropic medication (in line with this guideline) under the direction of a psychiatrist. Feasibility and acceptability development work should involve collaborating with people with bipolar disorder and professionals to demonstrate sustainable service delivery and recruitment, and identify and address possible barriers to such a service. Clinical outcomes should include time to next bipolar episode, mania and depression symptoms, function, recovery and quality of life. Economic outcomes should consider health, social care and personal costs.

Source guidance details

Comes from guidance
Bipolar disorder: assessment and management
Number
CG185
Date issued
September 2014

Other details

Is this a recommendation for the use of a technology only in the context of research? No  
Is it a recommendation that suggests collection of data or the establishment of a register?   No  
Last Reviewed 15/10/2014