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Open Access Highly Accessed Study protocol

Collaborative care for patients with bipolar disorder: a randomised controlled trial

Trijntje YG van der Voort1*, Berno van Meijel2, Peter JJ Goossens3, Janwillem Renes4, Aartjan TF Beekman5 and Ralph W Kupka6

Author Affiliations

1 GGZ ingeest/VU University Medical Center, dept. of Psychiatry, Amsterdam, the Netherlands; Inholland University of Applied Sciences, Research Group Mental Health Nursing, Amsterdam, the Netherlands; Dimence Mental Health, Deventer, the Netherlands

2 Inholland University of Applied Sciences, Research Group Mental Health Nursing, Amsterdam, the Netherlands

3 Dimence Mental Health, Deventer, the Netherlands; Radboud University Medical Center, Nijmegen, the Netherlands; Saxion University of Applied Sciences, Deventer, the Netherlands

4 Altrecht Institute for Mental Health Care, Utrecht, the Netherlands

5 VU University Medical Center, dept. of Psychiatry, Amsterdam, the Netherlands

6 VU University Medical Center, dept. of Psychiatry, Amsterdam, the Netherlands; Altrecht Institute for Mental Health Care, Utrecht, The Netherlands

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BMC Psychiatry 2011, 11:133  doi:10.1186/1471-244X-11-133

Published: 17 August 2011

Abstract

Background

Bipolar disorder is a severe mental illness with serious consequences for daily living of patients and their caregivers. Care as usual primarily consists of pharmacotherapy and supportive treatment. However, a substantial number of patients show a suboptimal response to treatment and still suffer from frequent episodes, persistent interepisodic symptoms and poor social functioning. Both psychiatric and somatic comorbid disorders are frequent, especially personality disorders, substance abuse, cardiovascular diseases and diabetes. Multidisciplinary collaboration of professionals is needed to combine all expertise in order to achieve high-quality integrated treatment. 'Collaborative Care' is a treatment method that could meet these needs. Several studies have shown promising effects of these integrated treatment programs for patients with bipolar disorder. In this article we describe a research protocol concerning a study on the effects of Collaborative Care for patients with bipolar disorder in the Netherlands.

Methods/design

The study concerns a two-armed cluster randomised clinical trial to evaluate the effectiveness of Collaborative Care (CC) in comparison with Care as usual (CAU) in outpatient clinics for bipolar disorder or mood disorders in general. Collaborative Care includes individually tailored interventions, aimed at personal goals set by the patient. The patient, his caregiver, the nurse and the psychiatrist all are part of the Collaborative Care team. Elements of the program are: contracting and shared decision making; psycho education; problem solving treatment; systematic relapse prevention; monitoring of outcomes and pharmacotherapy. Nurses coordinate the program. Nurses and psychiatrists in the intervention group will be trained in the intervention. The effects will be measured at baseline, 6 months and 12 months. Primary outcomes are psychosocial functioning, psychiatric symptoms, and quality of life. Caregiver outcomes are burden and satisfaction with care.

Discussion

Several ways to enhance the quality of this study are described, as well as some limitations caused by the complexities of naturalistic treatment settings where not all influencing factors on an intervention and the outcomes can be controlled.

Trial Registration

The Netherlands Trial Registry, NTR2600.