Bipolis® a therapeutic patient education program, intended for people suffering from bipolar disorders (1) allows in the short term to reduce the severity of hospitalizations. In the longer term, this program also reduces the number of hospitalizations following the end of the program and particularly the Free Hospitalization (HL) mode. Ambulatory destabilizations are similarly reduced over the same period. This program is also associated with improving the quality of life of patients.
Goals
Bipolis® is a therapeutic patient education program for people suffering from bipolar disorders, designed and implemented by Dr. Barbara Combes. We studied its impact on recurrences of bipolar disorder, on perceived quality of life, as well as on the degree of patient satisfaction for participation in the BIPOLIS® program.
Method
Our work constitutes a retrospective survey, concerning bipolar patients treated in therapeutic education with the Bipolis® Patient Therapeutic Education Program (PETP) (Exposé group) between March 2009 and July 2017, compared to a sample of matched controls on sex, age and year of start of follow-up at the consultation centre, who did not follow PETP Bipolis® (group Not Exposed). Treatment with PETP Bipolis® in these patients is not exclusive and does not replace other conventional methods of treatment. This is why all patients in the Exposed and Unexposed groups benefit from medical follow-up for their bipolar pathology within or outside the CHG Marchant in Toulouse. This study consists of the analysis of the data contained in the medical file of the patients and the passing of a telephone questionnaire. We included 55 patients in the Exposed group and 50 in the Unexposed group.
Results
Our study makes it possible to establish a significant link between Bipolis® and the number of hospitalizations in the two years, then the five years following the end of the program. We observe, in fact, an 80% reduction in forced hospitalizations, in the form of Admissions to Psychiatric Care at the Request of a Third Party (ASPDT) in the two years following the end of the program. In the five years following the end of the program, we find that the implementation of the Bipolis® program is associated, in a significant way, with an overall reduction in hospitalizations (all categories combined) and more specifically with 41.17% of hospitalizations in Free Hospitalization ( HL), but also to a 34.62% decrease in destabilizations treated on an outpatient basis. These results are to be linked to the improvement in the patients’ perception of their state of mental and physical health, to the understanding and acceptance of the treatment and finally to the knowledge of the non-drug strategies completing the stabilization objective. Bipolis® also allows patients to feel less limited in the performance of domestic tasks, the creation of social ties, access to leisure and the implementation of projects. It also reduces the difficulties felt by patients in the workplace.
Conclusion
Bipolis® makes it possible in the short term to reduce the severity of hospitalizations; in fact, in the two years after the end of the program, we find an 80% reduction in ASPDT in the Exposed group compared to the Unexposed group. In the longer term, i.e. within five years, this program reduces the number of hospitalizations following the end of the program and particularly the Free Hospitalization (HL) mode. Ambulatory destabilizations are similarly reduced over the same period. This program is also associated with improving the quality of life of patients.
The full text of this article is available in PDF. “Evaluation of the effects of the Bipolis® therapeutic education program on the health course of participants between March 2009 and July 2017”, Annales médico-psychologiques, Elsevier Masson, 2023
(1) Thinking about and practicing TPE in psychiatry. The BIPOLIS® program, Barbara Combes-DeslaugiersMental Health editions, 2017, 12 euros