Improving Compliance with Evidence-Based Practice Guidelines for Bipolar I Depression Treatment by Mental Health Clinicians
Abstract
**Please note that the full text is embargoed** ABSTRACT: Background: A large body of literature describes poor compliance among mental health
providers with evidence-based practice (EBP) guidelines for Bipolar Disorder (BD) I depression
treatment. Poor compliance to EBP guidelines has been linked to unfavorable patient outcomes.
Specifically, the use of antidepressants (AD) in the treatment of BD has been linked to flares of
mania and hypomania. Despite the ineffectiveness of these drugs, clinicians continue to use
them. At one mental health primary care site, a lack of compliance with EBP guidelines for AD
use in BD I depression was found. The purpose of this project was to implement a quick
reference tool to improve clinicians' compliance to EBP standards regarding use of AD for BD I
depression treatment. Methods: A one-group pretest/posttest design was used to evaluate the
effectiveness of the reference tool implementation. Convenience sampling was used to identify
18 electronic medical records (EMR) from two mental health clinicians, for use of AD in BD
treatment. Data was collected on an Excel spreadsheet, and results were analyzed with SPSS
23.0 for Social Scientists, using the non-parametric Wilcoxon signed-rank test. Results: A
significant difference was found between the pre- and post-EBP compliance scores (Z = -2.326, p
= 0.020). AD use was reduced from 94% to 83%. This implies that a quick reference tool may
have influenced the level of EBP compliance by mental health providers managing BD.
Conclusion: The use of EBP guidelines in the clinical setting was beneficial for implementing
the best practices for the management of BD, and promotes improvements in patient care for this
population.