Association Between Therapeutic Alliance, Care Satisfaction, and Pharmacological Adherence in Bipolar Disorder

Abstract

Objectives We sought to understand the association of specific aspects of care satisfaction, such as patients’ perceived relationship with their psychiatrist and access to their psychiatrist and staff, and therapeutic alliance with participants’ likelihood to adhere to their medication regimens among patients with bipolar disorder. Methods We examined data from the multicenter Systematic Treatment Enhancement Program for Bipolar Disorder, an effectiveness study investigating the course and treatment of bipolar disorder. We expected that participants (n = 3037) with positive perceptions of their relationship with their psychiatrist and quality of psychopharmacologic care, as assessed by the Helping Alliance Questionnaire and Care Satisfaction Questionnaire, would be associated with better medication adherence. We utilized logistic regression models controlling for already established factors associated with poor adherence. Results Patients’ perceptions of collaboration, empathy, and accessibility were significantly associated with adherence to treatment in individuals with bipolar disorder completing at least 1 assessment. Patients’ perceptions of their psychiatrists’ experience, as well as of their degree of discussing medication risks and benefits, were not associated with medication adherence. Conclusions Patients’ perceived therapeutic alliance and treatment environment impact their adherence to pharmacotherapy recommendations. This study may enable psychopharmacologists’ practices to be structured to maximize features associated with greater medication adherence.

Canadian Network for Mood and Anxiety Treatments (CANMAT) and International Society for Bipolar Disorders (ISBD) 2018 guidelines for the management of patients with bipolar disorder

“…A strong therapeutic alliance is central to improve treatment adherence and outcomes 59, 60. Providers should encourage individuals to actively participate in treatment planning, using a shared decision‐making approach 61, 62.…”

Petrificación epistémica y la restauración de la confiabilidad epistémica: Una nueva conceptualización del trastorno límite de la personalidad y su tratamiento psicosocial

“…Los intentos por atribuir las dificultades en línea con la ideología etiológica no están sólo mal colocados, sino que son rotundamente poco éticao. Sin embargo, la psicoterapia, y quizás inclusive la sensible administración de terapias biológicas (ej., Sylvia et al, 2013), esta principalmente preocupada no con el qué sino con el cómo del aprendizaje. La mentalización establece una visión de la persona como agente.…”

Evaluation of a Diabetes Management Program for Persons with Serious and Persistent Mental Illness

“…A study by Sylvia et al (2013) Findings showed the patients' perceptions of collaboration, accessibility and empathy were significantly associated with adherence to treatment (Sylvia et al).…”

“…Individualized coaching and reinforcement are necessary to apply and maintain learning (Bachrach, 2000;McDevitt et al, 2003). Therapeutic relationships are important to reinforce self-management and encourage treatment adherence (Sylvia et al, 2013) Next, the theoretical framework guiding this program evaluation will be presented.…”