title: Bipolar disorder center for Pennsylvanians: implementing an effectiveness trial to improve treatment for at-risk patients.
abstract: OBJECTIVE
  Adolescents, elderly persons, African Americans, and rural residents with bipolar disorder are less likely than their middle-aged, white, urban counterparts to be diagnosed, receive adequate treatment, remain in treatment once identified, and have positive outcomes. The Bipolar Disorder Center for Pennsylvanians (BDCP) study was designed to address these disparities. This report highlights the methods used to recruit, screen, and enroll a cohort of difficult-to-recruit individuals with bipolar disorder.
  
  
  METHODS
  Study sites included three specialty clinics for bipolar disorder in a university setting and a rural behavioral health clinic. Study operations were standardized, and all study personnel were trained in study procedures. Several strategies were used for recruitment.
  
  
  RESULTS
  It was possible to introduce the identical assessment and screening protocol in settings regardless of whether they had a history of implementing research protocols. This protocol was also able to be used across the age spectrum, in urban and rural areas, and in a racially diverse cohort of participants. Across the four sites 515 individuals with bipolar disorder were enrolled as a result of these methods (69 African Americans and 446 non-African Americans). Although clinical characteristics at study entry did not differ appreciably between African Americans and non-African Americans, the pathways into treatment differed significantly.
  
  
  CONCLUSIONS
  Rigorous recruitment and assessment procedures can be successfully introduced in different settings and with different patient cohorts, thus facilitating access to high-quality treatment for individuals who frequently do not receive appropriate care for bipolar disorder.
authors: Department of Psychiatry, University of Pittsburgh School of Medicine, Western Psychiatric Institute and Clinic, 3811 O'Hara St., Pittsburgh, PA 15213, USA. kupferdj@upmc.edu
authors: David J
authors: DJ
authors: Kupfer
authors: David A
authors: DA
authors: Axelson
authors: Boris
authors: B
authors: Birmaher
authors: Charlotte
authors: C
authors: Brown
authors: David E
authors: DE
authors: Curet
authors: Andrea
authors: A
authors: Fagiolini
authors: Ellen
authors: E
authors: Frank
authors: Edward S
authors: ES
authors: Friedman
authors: Victoria J
authors: VJ
authors: Grochocinski
authors: Patricia R
authors: PR
authors: Houck
authors: Amy M
authors: AM
authors: Kilbourne
authors: Benoit H
authors: BH
authors: Mulsant
authors: Bruce G
authors: BG
authors: Pollock
authors: Charles F
authors: CF
authors: Reynolds
authors: Mary G
authors: MG
authors: Stofko
authors: Holly A
authors: HA
authors: Swartz
authors: Michael E
authors: ME
authors: Thase
authors: Scott R
authors: SR
authors: Turkin
authors: Ellen M
authors: EM
authors: Whyte
mesh_terms: D000293:Adolescent; D000328:Adult; D001741:Black or African American / Q000523:psychology*; D000368:Aged; D000465:Algorithms; D001714:Bipolar Disorder / Q000175:diagnosis / Q000523:psychology / Q000534:rehabilitation*; D015331:Cohort Studies; D003131:Combined Modality Therapy; D003155:Community Mental Health Centers / Q000458:organization & administration*; D019468:Disease Management; D005260:Female; D006284:Health Plan Implementation / Q000458:organization & administration; D054625:Healthcare Disparities; D006801:Humans; D007318:Inservice Training / Q000458:organization & administration; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009720:Nurse Clinicians; D010043:Outcome and Process Assessment, Health Care; D010348:Patient Care Team / Q000458:organization & administration; D018579:Patient Selection; D017410:Practice Guidelines as Topic; D011619:Psychotropic Drugs / Q000008:administration & dosage / Q000627:therapeutic use; D012424:Rural Population; D055502:Secondary Prevention; D055815:Young Adult
chemical_list: D011619:Psychotropic Drugs