Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Email this article to a Colleague Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to My Articles & Searches Download to citation manager Citing Articles via HighWire Citing Articles via Google Scholar Articles by Marcus, S. C. Articles by Kupfer, D. J. Search for Related Content PubMed Citation Articles by Marcus, S. C. Articles by Kupfer, D. J. Bipolar Disorder Lithium Other Somatic Therapy

Therapeutic Drug Monitoring of Mood Stabilizers in Medicaid Patients With Bipolar Disorder

OBJECTIVE: The authors' goal was to determine the extent and pattern of blood serum monitoring of mood stabilizers in Medicaid patients with bipolar disorder. METHOD: Data were drawn from a Medicaid medical claims data set from Pittsburgh and the surrounding region. The authors identified bipolar patients using lithium, valproate, and carbamazepine (N=718) and then examined the patient demographic, diagnostic, and service use variables associated with therapeutic drug monitoring. RESULTS: A substantial proportion of lithium users (36.5%), valproate users (42.4%), and carbamazepine users (42.2%) with bipolar disorder diagnoses did not receive therapeutic drug level testing during the 12-month study period. Carbamazepine users who were male or in the 30–49-year age range were significantly less likely to be tested for serum drug level. Lithium users who did not receive partial-hospitalization psychiatric services and valproate users who received mental health case management were also less likely to be tested for serum drug level. Over one-half of the lithium users (54.1%) did not receive thyroid function tests, and few (4.2%) received renal function tests. Patients who did receive tests for serum drug level were likely to receive the other recommended tests. CONCLUSIONS: Many Medicaid patients with bipolar disorder received no therapeutic drug monitoring. Patient sociodemographic characteristics contributed little to explaining this omission, although some types of service utilization were related to rates of serum drug level testing.

This article has been cited by other articles:

				A. B. Busch, H. A. Huskamp, and M. B. Landrum Quality of Care in a Medicaid Population With Bipolar I Disorder Psychiatr Serv, June 1, 2007; 58(6): 848 - 854. [Abstract] [Full Text] [PDF]

				A. B. Busch, D. Ling, R. G. Frank, and S. F. Greenfield Changes in the Quality of Care for Bipolar I Disorder During the 1990s Psychiatr Serv, January 1, 2007; 58(1): 27 - 33. [Abstract] [Full Text] [PDF]

				W S A Smellie, J Forth, S Ryder, M J Galloway, A C Wood, and I D Watson Best practice in primary care pathology: review 5 J. Clin. Pathol., December 1, 2006; 59(12): 1229 - 1237. [Abstract] [Full Text] [PDF]

				R. C. Hermann, J. A. Chan, S. E. Provost, and W. T. Chiu Statistical Benchmarks for Process Measures of Quality of Care for Mental and Substance Use Disorders Psychiatr Serv, October 1, 2006; 57(10): 1461 - 1467. [Abstract] [Full Text] [PDF]

				K. E. Lasser, D. L. Seger, D. T. Yu, A. S. Karson, J. M. Fiskio, A. C. Seger, N. R. Shah, T. K. Gandhi, J. M. Rothschild, and D. W. Bates Adherence to black box warnings for prescription medications in outpatients. Arch Intern Med, February 13, 2006; 166(3): 338 - 344. [Abstract] [Full Text] [PDF]

				C. Blanco, G. Laje, M. Olfson, S. C. Marcus, and H. A. Pincus Trends in the Treatment of Bipolar Disorder by Outpatient Psychiatrists Am J Psychiatry, June 1, 2002; 159(6): 1005 - 1010. [Abstract] [Full Text] [PDF]

Get information about faster international access.

Privacy Policy

Copyright © 1999 American Psychiatric Association. All rights reserved.

Home | Search | Current Issue | Past Issues | Subscribe | All APPI Journals | Help | Contact Us