TY - JOUR
KW - Bipolar Disorder/diagnosis/epidemiology
KW - Chi-Square Distribution
KW - Depression/diagnosis/epidemiology
KW - Female
KW - Humans
KW - Male
KW - Mass Screening/methods
KW - Medical Records Systems, Computerized/instrumentation
KW - Mental Health
KW - Practice Guidelines as Topic
KW - Primary Health Care
KW - Prospective Studies
KW - Psychometrics
KW - Questionnaires
KW - Risk Factors
AU - J. M. Gill
AU - Y. X. Chen
AU - A. Grimes
AU - M. S. Klinkman
A1 - 
AB - PURPOSE: National guidelines recommend screening all persons with depression for bipolar disorder (BPD); one way to facilitate screening is through the use of electronic health records (EHRs). This study examined the impact of an EHR-based screening and decision support tool on diagnosis and treatment of BPD among patients diagnosed with depression in primary care offices. METHODS: This nonrandomized, controlled trial was conducted in a national network of offices using EHRs. The intervention included a screening instrument and other tools for diagnosis and management of BPD, which were embedded into the EHR. This instrument automatically activated when a patient with a diagnosis of depression but no diagnosis of BPD was seen in the office. The primary outcomes were the rates of new diagnoses of BPD and prescription of new BPD medications during the 6-month study period (April to October 2009). RESULTS: Twenty-one offices with 75 clinicians and 8355 adult patients with depression composed the intervention group, whereas 17 offices with 81 clinicians and 8799 adult patients with depression served as the comparison group. The screening tool was used with 47.5% of intervention patients, of whom 2.5% scored at high or very high risk for BPD. Intervention patients were more likely than comparison patients to be newly diagnosed with BPD (1.11% vs. 0.36%; P < .01) and be prescribed new BPD medications (1.85% vs. 1.19%; P < .01). CONCLUSIONS: The study suggests that EHR-based tools can be useful for screening and management of BPD for patients with depression in primary care offices.
BT - Journal of the American Board of Family Medicine : JABFM
C5 - HIT & Telehealth
CP - 3
CY - United States
DO - 10.3122/jabfm.2012.03.110217
IS - 3
JF - Journal of the American Board of Family Medicine : JABFM
N2 - PURPOSE: National guidelines recommend screening all persons with depression for bipolar disorder (BPD); one way to facilitate screening is through the use of electronic health records (EHRs). This study examined the impact of an EHR-based screening and decision support tool on diagnosis and treatment of BPD among patients diagnosed with depression in primary care offices. METHODS: This nonrandomized, controlled trial was conducted in a national network of offices using EHRs. The intervention included a screening instrument and other tools for diagnosis and management of BPD, which were embedded into the EHR. This instrument automatically activated when a patient with a diagnosis of depression but no diagnosis of BPD was seen in the office. The primary outcomes were the rates of new diagnoses of BPD and prescription of new BPD medications during the 6-month study period (April to October 2009). RESULTS: Twenty-one offices with 75 clinicians and 8355 adult patients with depression composed the intervention group, whereas 17 offices with 81 clinicians and 8799 adult patients with depression served as the comparison group. The screening tool was used with 47.5% of intervention patients, of whom 2.5% scored at high or very high risk for BPD. Intervention patients were more likely than comparison patients to be newly diagnosed with BPD (1.11% vs. 0.36%; P < .01) and be prescribed new BPD medications (1.85% vs. 1.19%; P < .01). CONCLUSIONS: The study suggests that EHR-based tools can be useful for screening and management of BPD for patients with depression in primary care offices.
PP - United States
PY - 2012
SN - 1557-2625; 1557-2625
SP - 283
EP - 290
EP - 
T1 - Using electronic health record-based tools to screen for bipolar disorder in primary care patients with depression
T2 - Journal of the American Board of Family Medicine : JABFM
TI - Using electronic health record-based tools to screen for bipolar disorder in primary care patients with depression
U1 - HIT & Telehealth
U2 - 22570391
U3 - 10.3122/jabfm.2012.03.110217
VL - 25
VO - 1557-2625; 1557-2625
Y1 - 2012
ER -