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Specialist program reduces hospital readmissions in bipolar disorder

After completing the specialist program OPTIMA at South London and Maudsley NHS Foundation Trust in the U.K., patients with bipolar disorder were significantly less likely to be readmitted to hospital, according to study findings.

“The period immediately following hospital admission for mania or bipolar depression is an important opportunity to optimize treatment and to prevent episode recurrence,” Karine Macritchie, MD, from South London and Maudsley NHS Foundation Trust, and colleagues wrote. “OPTIMA’s core program aims to consolidate recovery for people with bipolar disorder who have recently required a hospital admission or home treatment team care for an episode of mania or depression.”

The program focuses on patients who have required frequent hospital admissions, offering an individually tailored treatment that includes ongoing psychiatric assessment, psychotropic medication prescription, specialist nursing, occupational therapy and psychoeducation.

Researchers conducted a preliminary audit to compare demographic data and rates of hospital admissions and home treatment team spells in patients before entry to and 3 years after discharge from OPTIMA. The study focused on patients admitted to the program between April 2015 and March 2017 who were later discharged.

In total, 30 patients were discharged from the OPTIMA program. The median number of months since discharge from the program was 9.5, and the median monthly rate of hospital admission after OPTIMA was significantly lower than the rate in the 3 years before the program, according to the findings.

In addition, the median monthly rate of home treatment team episodes after OPTIMA was lower than the rate before the program, though this difference did not reach significance.

“A growing body of evidence supports the need for and the effectiveness of specialist services, particularly in the case of complex and disabling illnesses, such as bipolar disorder,” Macritchie and colleagues wrote.

“Our initial findings support the importance of frequent specialist post-episode psychiatric review and maintenance phase interventions to stabilize bipolar disorder in frequently admitted patients,” they continued. “Future work will include the expansion of this model of care in the development of an OPTIMA ward liaison service to improve continuity of care from the in-patient to the community setting, and recruitment to the OPTIMA core program.” – by Savannah Demko

Disclosure: The authors report no relevant financial disclosures.