Changing practice: assessing attitudes toward a NICE-informed collaborative treatment pathway for bipolar disorder

BJPsych Open. 2021 Mar 8;7(2):e64. doi: 10.1192/bjo.2021.22.

Abstract

Background: Bipolar disorder is a chronic mental health condition, which can result in functional impairment despite medication. A large evidence base supports use of psychological therapies and structured care in the treatment of mood disorders, but these are rarely implemented. e-Pathways are digital structures that inform and record patient progress through a healthcare system, although these have not yet been used for bipolar disorder.

Aims: To assess the perceived benefits and costs associated with implementing a collaborative NICE-informed e-pathway for bipolar disorder.

Method: Healthcare professionals and people with bipolar disorder attended a workshop to share feedback on e-pathways. Data were collected through questionnaires (n = 26) and transcription of a focus group, analysed qualitatively by a framework analysis.

Results: Patients and healthcare professionals welcomed the development of an e-pathway for bipolar disorder. There were five elements to the framework: quality and delivery of care, patient-clinician collaboration, flexibility and adaptability, impact on staff and impact on healthcare services.

Conclusions: Identification of benefits and costs ensures that future development of e-pathways addresses concerns of healthcare professionals and people with bipolar disorder, which would be essential for successful implementation. Recommendations for this development include making e-pathways less complicated for patients, ensuring sufficient training and ensuring clinicians do not feel their skills become invalidated. Limitations of the study, and directions for future research, are discussed.

Keywords: Bipolar affective disorders; care pathway; change management; e-pathway; qualitative research.