Outcomes for bipolar patients assessed in the French expert center network: A 2-year follow-up observational study (FondaMental Advanced Centers of Expertise for Bipolar Disorder [FACE-BD])
Outcomes for bipolar patients assessed in the French expert center network: A 2-year follow-up observational study (FondaMental Advanced Centers of Expertise for Bipolar Disorder [FACE-BD])
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DOI：
10.1111/bdi.12539
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发表时间：
2017-12-01
影响因子：
5.4
通讯作者：
Etain, Bruno
中科院分区：
文献类型：
--
作者：
Henry, Chantal;Godin, Ophelia;Etain, Bruno
目的在 FondaMental 基金会的支持下，法国建立了针对双相情感障碍患者的新医疗保健系统，该系统基于对患者的全面临床评估以及专家中心和转诊从业人员之间的密切合作。我们报告了对网络内评估的成年患者进行 2 年观察性随访后的结果。 方法 本研究共纳入 984 名患者。我们比较了入组前 1 年和观察随访 2 年后的几个参数（例如，情绪发作和住院情况），并使用患者作为自己的对照。在基线和随访期间比较其他结果。我们使用连续参数的混合模型和分类变量的广义估计方程 (GEE) 模型来估计这些参数在 2 年时间内的演变，并调整潜在的混杂因素。结果平均年龄为 42.7(12.5) 岁，其中 58.8% 为女性。与纳入前一年与随访期间相比，住院天数减少了 55%。此外，患者表现出明显的功能改善，与残留情绪症状减少、精神合并症减少、睡眠改善和更好地坚持治疗相关。结论本研究表明，在双相情感障碍专家中心进行评估后，经过两年的随访，患者的总体改善。这个新组织基于全面的临床评估和向医疗保健专业人员发送的个性化建议（药物治疗、心理社会策略和生活方式措施），并积极让患者和家属参与，改善了双相情感障碍患者的预后。
ObjectiveA new health care system for patients with bipolar disorders was established in France under the auspices of Fondation FondaMental, based on thorough clinical assessment of patients and on close collaborations between expert centers and referring practitioners. We report the results of outcomes after 2years of observational follow-up of adult patients assessed within the network.MethodA total of 984 patients were included in the study. We compared several parameters (e.g., mood episodes and hospitalization) 1year before inclusion and after 2 years of observational follow-up using the patient as his or her own control. Other outcomes were compared at baseline and during follow-up. We estimated the evolution of these parameters over a period of 2years using mixed models for continuous parameters and a generalized estimating equation (GEE) model for categorical variables, adjusting for potential confounding factors.ResultsMean age was 42.7(12.5) years and 58.8% were women. The number of hospitalization days decreased by 55% when comparing 1year before inclusion vs the follow-up period. In addition, patients showed a clear functional improvement associated with a reduction of residual mood symptoms, diminished psychiatric comorbidities, improvement of sleep and a better adherence to treatment.ConclusionsThis study demonstrates an overall improvement of patients followed for 2years after an assessment in expert centers for bipolar disorders. This new organization based on a thorough clinical assessment and on personalized recommendations (drug treatments, psycho-social strategies and lifestyle measures) sent to health care professionals, and actively involving patients and families, improves the prognosis of BD patients.