title: Integrating bipolar disorder management in primary care.
abstract: There is growing realization that persons with bipolar disorder may exclusively be seen in primary (general medical) care settings, notably because of limited access to mental health care and stigma in seeking mental health treatment. At least two clinical practice guidelines for bipolar disorder recommend collaborative chronic care models (CCMs) to help integrate mental health care to better manage this illness. CCMs, which include provider guideline support, self-management support, care management, and measurement-based care, are well-established in primary care settings, and may help primary care practitioners manage bipolar disorder. However, further research is required to adapt CCMs to support complexities in diagnosing persons with bipolar disorder, and integrate decision-making processes regarding medication safety and tolerability in primary care. Additional implementation studies are also needed to adapt CCMs for persons with bipolar disorder in primary care, especially those seen in smaller practices with limited infrastructure and access to mental health care.
authors.affiliation: VA Ann Arbor Center for Clinical Management Research, 2215 Fuller Road, Mail Stop 152, Ann Arbor, MI 48105, USA. amykilbo@umich.edu
authors.forename: Amy M
authors.initials: AM
authors.lastname: Kilbourne
authors.forename: David E
authors.initials: DE
authors.lastname: Goodrich
authors.forename: Allison N
authors.initials: AN
authors.lastname: O'Donnell
authors.forename: Christopher J
authors.initials: CJ
authors.lastname: Miller
mesh_terms: D001714:Bipolar Disorder / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy; D002908:Chronic Disease / Q000628:therapy; D017281:Cost of Illness; D006297:Health Services Accessibility; D006301:Health Services Needs and Demand / Q000191:economics / Q000458:organization & administration; D006801:Humans; D008605:Mental Health Services / Q000191:economics / Q000458:organization & administration*; D017410:Practice Guidelines as Topic; D011320:Primary Health Care / Q000191:economics / Q000458:organization & administration*; D014481:United States / Q000453:epidemiology