Assessing the treatment adherence and clinical correlates of low adherence among bipolar disorder outpatients: a cross-sectional study

Abstract

OBJECTIVE: The aim of this study was to assess sociodemographic and clinical correlates of poor treatment adherence among outpatients with bipolar disorder (BD) in remission period. METHODS: This was a cross-sectional study carried out in a University Hospital in Turkey, and 117 outpatients with BD according to DSM-IV-TR criteria were included. All participants were administered a sociodemographic form, the SCID-I, the Morisky 8-item Medication Adherence Questionnaire, the Hamilton Depression Scale, the Young Mania Rating Scale, Schedule for Assessing the three components of insight, and Global Assessment of Functioning Scale. Collected data were analysed via descriptive statistics and logistic regression was used to determine significant variables. RESULTS: Patients with poor treatment adherence were low educated, were more likely to be not married, and had a greater prevalence of anxiety disorder comorbidity. The patients with poor adherence also showed more subsyndromal depressive symptoms but no significant differences were seen in terms of age, gender, living status, social support, or number of episodes between patients with good and poor adherence. Logistic regression analyses revealed that comorbid anxiety disorder, lower education level, and duration of depression period were the main predictors of poor adherence. CONCLUSION: This outcome is consistent with previous studies, and assuring complete adherence in all bipolar patients is difficult, but increasing the number of adherent patients is possible and substantial for sufficient outcome. Improving subsyndromal symptoms and awareness of the patient about the features of the disorder may provide better adherence to treatment and greater functionality of the patient. Psychotherapeutic interventions and psychoeducation should be implemented along with the medical treatment to improve subsyndromal symptoms and to avoid treatment maladherence in advance. Further research is needed to assess the role of interventions in treatment adherence of patients with BD.

Psycho-demographic and clinical predictors of medication adherence in patients with bipolar I disorder in a university hospital in Egypt

“…These results are inconsistent with the literature, which indicates that poorly adherent patients showed worse functioning compared with those with high levels of adherence. 53,55 In their follow-up study, Novick et al 56 identified a positive association between functioning and treatment adherence at baseline, in agreement with our results, yet a slightly negative association on follow-up after a year of treatment of bipolar patients.…”

Assessments of functional outcomes and its determinants among bipolar disorder patients in Northwest Ethiopia comprehensive specialized hospitals: a multicenter hospital-based study

“…Poor adherence to the treatment may increase relapse rates, hospital attendance, and poor medication response and community adjustment. Furthermore, being non-adherent to the given medications might cause exacerbations of social and work-related impairments and increase the prevalence of comorbidity, prolonged depression, and compromise educational levels [ 49 , 50 ]. Non-adherence also causes a decrease in QOL, increases suicidal attempts, and sharply increases both personal and financial costs [ 51 ].…”

Impact of nurse‐led medication adherence therapy on bipolar affective disorder: A randomized controlled trial

“…This outcome is consistent with the previous studies, in the case of bipolar disorder, patients are likely to be more adherent to medications that reduce the severity of depressive episodes (Johnson et al, 2007), improving subsyndromal symptoms and awareness of the patient about the features of the disorder may provide better adherence to treatment and greater functionality of the patient. Psychotherapeutic interventions and psychoeducation should be implemented along with the medical treatment to improve subsyndromal symptoms and to avoid treatment nonadherence in advance (Karadağ et al, 2019), unlikely not all the studies have concluded a negative correlation between medication adherence and symptom severity (Jónsdóttir et al, 2013; Rosa et al, 2007).…”