Therapeutic Tolerability and Adherence in Bipolar Disorder

Overview

Involving patients in designing their own treatment strategies according to their tolerability criteria can help combat the 90% nonadherence rate in patients being treated for bipolar disorder. Find out from experts about best practices in addressing patient concerns and balancing tolerability with efficacy and adherence in treating patients with bipolar disorder.

Learning Objective

After completing the educational activities, learners will be able to:

  • Provide efficacious and tolerable maintenance treatment for patients with bipolar I disorder
  • Select a treatment regimen (monotherapy or combination treatment) to alleviate bipolar depression without causing the patient an undue side effect burden

Target Audience

Psychiatrists & psychiatry NPs and PAs; primary care physicians, NPs, and PAs

Program Description

The saying “The cure can’t be worse than the disease” rings particularly true when it comes to managing patient adherence in the treatment of bipolar disorder. With a limited number of treatment options available, implementing a shared decision-making model is essential in creating an environment that maximizes success for the patient. Including their concerns with tolerability in the decision-making process while evaluating evidence can help design a therapeutic plan that assists the patient in realizing their treatment goals. In this video three field experts and a patient offer insights into best approaches for including patient preferences and evaluating efficacy while choosing therapeutic strategies that achieve better medication adherence in patients with bipolar disorder.

Part of the Bipolar Disorder Education Collection

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Screening and Accurate Diagnosis of Patients With Bipolar Disorder Type I and Type II
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Treatment Options for Bipolar I and Bipolar II Disorder
As novel agents join the treatment landscape for bipolar I and bipolar II disorder and new data emerge on existing therapeutics, clinicians need education on the latest evidence of the safety and efficacy profiles of existing and emerging treatments for bipolar I and bipolar II disorder. Join Drs Goldberg, DelBello, and Swartz in examining how to integrate this information into clinical practice and provide efficacious and tolerable treatment for patients with bipolar I and bipolar II disorder.
Activity summary
Available credit: 
  • 0.50 AMA PRA Category 1 Credit™
  • 0.50 Participation
Activity opens: 
09/12/2022
Activity expires: 
09/30/2023
Cost:
$0.00

Support Statement

Supported by educational grants from Alkermes, Inc. and Intra-Cellular Therapies, Inc.

Learning Objective

After completing the educational activities, learners will be able to:

  • Provide efficacious and tolerable maintenance treatment for patients with bipolar I disorder
  • Select a treatment regimen (monotherapy or combination treatment) to alleviate bipolar depression without causing the patient an undue side effect burden

Release, Review, and Expiration Dates

This CME activity was published in September 2022 and is eligible for AMA PRA Category 1 Credit™ through September 30, 2023.

Statement of Need and Purpose

Accurate diagnosis of bipolar I disorder is often delayed by years, while patients either go untreated or receive inappropriate treatment. Given the substantial illness burden, misdiagnosis is a critical unmet need. Additionally, treatment options for bipolar I disorder have expanded. The importance of certain side effects to patients should be discussed to improve the therapeutic alliance and their adherence.
Clinicians need education on clinical presentations, the use of screening tools, and differential diagnosis of bipolar I disorder. Education is also needed about evidence on the efficacy and tolerability of treatments for bipolar I disorder to enable clinicians to select a regimen that alleviates a patient’s symptoms without causing an undue burden of side effects.

Clinicians too often misdiagnose bipolar depression. Accurate diagnosis is often delayed by years, while patients either go untreated or receive inappropriate treatment. When bipolar disorder is treated, many clinicians fail to use measurement-based care to assess whether treatment changes are necessary. New treatments are on the horizon, and clinicians need education on:

  • Recognition of bipolar depression, e.g., risk factors, signs, assessment strategies 
  • Latest evidence on safety and efficacy of existing & emerging treatments for bipolar depression
  • Selection and implementation of monotherapy versus combination therapies based on guidelines and expert recommendations
  • Ongoing measurement-based care for bipolar depression to monitor efficacy and side effects and offer individualized treatment regimens

Unlabeled and Investigational Usage

The faculty of this educational activity may include discussions of products or devices that are not currently labeled for use by the FDA. Faculty members have been advised to disclose to the audience any reference to an unlabeled or investigational use.

No endorsement of unapproved products or uses is made or implied by coverage of these products or uses.

Please refer to the official prescribing information for each product for discussion of approved indicators, contraindications and warnings.

Review Process

The faculty members agreed to provide a balanced and evidence-based presentation and discussed the topics and CME objectives during the planning sessions. The faculty’s submitted content was validated by CME Institute staff, and the activity was evaluated for accuracy, use of evidence, and fair balance by the Chair and a peer reviewer who is without conflict of interest.

The opinions expressed herein are those of the faculty and do not necessarily reflect the opinions of the CME provider and publisher or the commercial supporter

© Copyright 2022 Physicians Postgraduate Press, Inc.

Faculty 

Joseph F. Goldberg, M.D.
Clinical Professor of Psychiatry
Icahn School of Medicine at Mount Sinai
New York, NY

 


Holly A. Swartz, M.D.
Professor of Psychiatry
University of Pittsburgh School of Medicine
Pittsburgh, PA 

 

Melissa P. DelBello, MD, MS
Professor of Psychiatry and Pediatrics
Dr. Stanley and Mickey Kaplan Professor and Chair
Department of Psychiatry and Behavioral Neuroscience
University of Cincinnati College of Medicine
Cincinnati, OH

Financial Disclosure

The CME Institute adheres to the Standards for Integrity and Independence in Accredited Continuing Education of the Accreditation Council for Continuing Medical Education (ACCME). Any individuals in a position to control the content of a continuing education activity, including faculty, content developers, reviewers, staff, and others, are required to disclose to learners the presence or absence of any relevant financial relationships with an ACCME-defined ineligible company within the preceding 24 months of the activity. The ACCME defines an “ineligible company” as one whose primary business is producing, marketing, selling, re-selling, or distributing healthcare products used by or on patients.

The CME Institute has mitigated all relevant conflicts of interest prior to the commencement of the activity. None of the individuals involved in the content have relevant financial relationships with ineligible companies except the following:

Dr DelBello has served as a consultant for Medscape, CME Inc., Sage, Myriad, Alkermes; received grant/research support from Shire, Alkermes, Acadia, Pfizer, Lundbeck, Johnson and Johnson and Otsuka; and has served on speakers/advisory boards for Myriad, Assurex, Sage, Alkermes and Johnson and Johnson. Dr Goldberg has served as a consultant for BioXcel, Intracellular Therapies, Jazz Pharmaceuticals, Lundbeck, Otsuka, Sunovion; received honoraria from Abbvie, Alkermes, Intracellular Therapies, Sunovion; has served on speaker/advisory boards for Jazz Pharmaceuticals, Lundbeck; and receives royalties from American Psychiatric Association Publishing and Cambridge University Press. Dr Swartz received honoraria from Medscape; has served on speaker/advisory boards for Intracellular Therapeutics; and receives royalties from Wolters Kluwer and American Psychiatric Association Publishing.

Accredited Provider Disclosure

Michael R. Page, PharmD, RPh
Independent Medical Director/Medical Writer
Plainsboro, New Jersey
Dr. Page is a consultant for BioCentric, Inc. and American Medical Communications, Inc.

None of the other planners, reviewers, and CME Institute staff for this educational activity have relevant financial relationships with ineligible companies to disclose. All relevant financial relationships have been mitigated.
 

Accreditation Statement

The CME Institute of Physicians Postgraduate Press, Inc., is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.

Credit Designation

The CME Institute of Physicians Postgraduate Press, Inc., designates this enduring material for a maximum of 0.50 AMA PRA Category 1 Credit™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Note: The American Nurses Credentialing Center (ANCC) and the American Academy of Physician Assistants (AAPA) accept certificates of participation for educational activities certified for AMA PRA Category 1 Credit™ from organizations accredited by the ACCME.

To obtain credit for this activity, study the material and complete the CME Posttest and Evaluation.

Available Credit

  • 0.50 AMA PRA Category 1 Credit™
  • 0.50 Participation

Price

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