Fostering Communication and Collaboration During Bipolar Disorder Treatment

Join Christoph Correll, MD, professor of psychiatry at Hofstra Northwell School of Medicine, New York, and medical director of the Recognition and Prevention program at the Zucker Hillside Hospital, New York, as he unravels the misconceptions, addresses concerns, and paves the way for informed choices in bipolar disorder management. In this video, Dr Correll explores how shared decision-making and motivational interviewing can empower patients to take an active role in their treatment, especially when considering long-acting injectable antipsychotics, and reveals the keys to fostering collaborative communication in health care decisions. 

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Read the Transcript: 

Psych Congress Network: Collaboration and communication are crucial in patient-centered care. How do you foster collaborative communication with patients to ensure they actively participate in their treatment decisions, especially when considering LAI antipsychotics?

Christoph Correll, MD: We're fortunately in an era now where the patient has entered the room and takes center stage. We're looking at patient-reported outcomes. But also, patients are advising us on research studies. In clinical care, we need to make sure we understand what's important to them. Shared decision making, motivational interviewing, these are buzzwords now, but not just because it's en vogue. Because it's important. Patients who are educated, and who feel that they're being taken seriously, are much better partners in making treatment decisions. There shouldn't be decisions about patients without them.

In order to have not just adherence, but medication interest that underlies, "I want to take the medication, I feel it's valuable for me," you need to understand what's important for the patient, and then link what's important to you as a health care professional, what you know helps the patient achieve those goals, to link them together, meaning you need to know what goals are relevant. Is it living independently? Wanting to be in education? Having friends? Maybe a partner? What about financial independence? Then understand that the medication stability, the symptom stability, and the functional outcome are linked to this. But in order to link the treatment and collaboration with the patient to their goals, you need to define smart goals. They need to be specific, measurable, attainable, relevant to the patient, and time bound. You shouldn't build castles up in the sky, but rather something that's attainable so that patients have a good experience.

Psych Congress Network: Can you share any best practices for addressing concerns or misconceptions that patients with bipolar disorder may have about LAI antipsychotic treatments, and how you help them make informed choices?

Dr Correll: Many patients, let's face it, haven't even heard about long-acting injectable antipsychotics, especially with bipolar disorder because clinicians are not thinking about them. So education is important. There are misconceptions. "Oh, my God. You're giving me all this medication at once? Will I not have toxic symptoms?" "Well, it's released very, very carefully." "But I can't make a change. You can't make a change. Is that right?" "That is true. We'll first start you on the oral medication anyway to find the right dose. Then it's just a continuation which is made easier." "Well, what about the needle? Isn't it very painful?" "Well, most patients really report very little pain. Needle phobia, even patients can adapt to that kind of a schedule." There are other misconceptions that they might not work as well, or there are more side effects. This is not true. They work basically better because patients are on an even keel. There might be some side effects that are lower in frequency because you have less peak-drop variation compared to the oral treatment. But that's important to discuss with the patient, and understand what their concerns might be, and then address them together.