Medication Adherence Among Adolescents with Bipolar Disorder

Goldstein, Tina R.; Krantz, Megan; Merranko, John; Garcia, Matthew; Sobel, Loren J.; Rodríguez, Carlos Javier Rincón; Douaihy, Antoine; Axelson, David; Birmaher, Boris

doi:10.1089/cap.2016.0030

Cited by 21 publications

(8 citation statements)

References 54 publications

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“…This was somewhat expected as previous research showed that adolescents tend to be less adherent to inhaled asthma therapy when compared with younger children or adults 45 46. Irrespective of the patients’ age, it is possible that both patients’ and physicians’ adherence estimates were overestimating real adherence, as previous research showed lower adherence levels to inhaled medications for asthma when using objective assessment methods4 and overestimation of subjective measures of adherence when compared with objective measures 15 18 47–49. However, in the present study, we did not collect objective data on inhaler adherence to support this assumption 47.…”

Section: Discussionmentioning

confidence: 45%

Patient-physician discordance in assessment of adherence to inhaled controller medication: a cross-sectional analysis of two cohorts

et al. 2019

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ObjectiveWe aimed to compare patient’s and physician’s ratings of inhaled medication adherence and to identify predictors of patient-physician discordance.DesignBaseline data from two prospective multicentre observational studies.Setting29 allergy, pulmonology and paediatric secondary care outpatient clinics in Portugal.Participants395 patients (≥13 years old) with persistent asthma.MeasuresData on demographics, patient-physician relationship, upper airway control, asthma control, asthma treatment, forced expiratory volume in one second (FEV1) and healthcare use were collected. Patients and physicians independently assessed adherence to inhaled controller medication during the previous week using a 100 mm Visual Analogue Scale (VAS). Discordance was defined as classification in distinct VAS categories (low 0–50; medium 51–80; high 81–100) or as an absolute difference in VAS scores ≥10 mm. Correlation between patients’ and physicians’ VAS scores/categories was explored. A multinomial logistic regression identified the predictors of physician overestimation and underestimation.ResultsHigh inhaler adherence was reported both by patients (median (percentile 25 to percentile 75) 85 (65–95) mm; 53% VAS>80) and by physicians (84 (68–95) mm; 53% VAS>80). Correlation between patient and physician VAS scores was moderate (rs=0.580; p<0.001). Discordance occurred in 56% of cases: in 28% physicians overestimated adherence and in 27% underestimated. Low adherence as assessed by the physician (OR=27.35 (9.85 to 75.95)), FEV1 ≥80% (OR=2.59 (1.08 to 6.20)) and a first appointment (OR=5.63 (1.24 to 25.56)) were predictors of underestimation. An uncontrolled asthma (OR=2.33 (1.25 to 4.34)), uncontrolled upper airway disease (OR=2.86 (1.35 to 6.04)) and prescription of short-acting beta-agonists alone (OR=3.05 (1.15 to 8.08)) were associated with overestimation. Medium adherence as assessed by the physician was significantly associated with higher risk of discordance, both for overestimation and underestimation of adherence (OR=14.50 (6.04 to 34.81); OR=2.21 (1.07 to 4.58)), while having a written action plan decreased the likelihood of discordance (OR=0.25 (0.12 to 0.52); OR=0.41 (0.22 to 0.78)) (R2=44%).ConclusionAlthough both patients and physicians report high inhaler adherence, discordance occurred in half of cases. Implementation of objective adherence measures and effective communication are needed to improve patient-physician agreement.

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Section: Discussionmentioning

confidence: 45%

Patient-physician discordance in assessment of adherence to inhaled controller medication: a cross-sectional analysis of two cohorts

et al. 2019

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“…Type of treatment and adherence to treatment can also influence the risk of recurrence. 41 However, we did not measure adherence and since the effects of treatment are confounded by indication, treatment was not included in the RC. The monitoring of symptoms using the PSR in research settings, and in our study, is more systematic than what is typically done in clinical practice.…”

Section: Discussionmentioning

confidence: 99%

Predicting Personalized Risk of Mood Recurrences in Youths and Young Adults With Bipolar Spectrum Disorder

Birmaher

Merranko

Gill

et al. 2020

Journal of the American Academy of Child & Adolescent Psych

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Objective: With each recurrence the prognosis of bipolar disorder (BD) worsens, indicating the need to identify the factors associated with increased recurrence risk. The course of BD is heterogenous and although risk factors for recurrence for the group as a whole have been reported in the literature, identification of risk factors for a specific individual are crucial for developing personalized treatments.Method: 363 recovered BD youths/young adults from the Course and Outcome of Bipolar Youth (COBY) study were included. Participants were evaluated on average every 7-months for a median of 12.5 years and interviewed with standard instruments.

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“…Nonadherence to psychotropic medication has shown to increase relapses, psychiatric rehospitalisation, and morbidity not only among adults but also among adolescents [ 5 , 6 ]. Particularly for adolescents with mental disorders, adherence to psychotropic medication is relatively low with only about two-thirds adhering to the prescribed medication [ 2 , 6 , 7 , 8 ]. Such limited adherence rate in this age group is quite worrisome, as nonadherence among adolescents can have specific disruptive effects on their life and development, such as social isolation, school difficulties, criminal records, unintended pregnancies, sexually transmitted diseases, and substance abuse, among others [ 2 , 3 ].…”

Section: Introductionmentioning

confidence: 99%

“…While the views, perceptions, and experiences of adults with mental disorders on the use of psychotropic medication have been thoroughly explored in the literature, little attention has been paid to those of adolescents [ 7 , 8 , 9 , 12 , 13 ]. It is well known that the experiences of adults with mental disorders cannot be generalised to younger populations, as the experiences of adolescents may be influenced by other factors.…”

Section: Introductionmentioning

confidence: 99%

Perceptions and Experiences of Adolescents with Mental Disorders and Their Parents about Psychotropic Medications in Turkey: A Qualitative Study

Dіkeç

Kardelen

González

et al. 2022

IJERPH

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This descriptive phenomenological study aimed to evaluate the perception and experiences of adolescents with mental disorders and their parents about the use of and adherence to psychotropic medications. A total of 12 semi-structured interviews with adolescents between the ages of 12 to 18 who were attending an outpatient psychiatric clinic for children and adolescents and 12 interviews with parents were conducted between October 2021 and January 2022 in Manisa, Turkey. Colaizzi’s phenomenological interpretation method was used for the analysis of the participants’ statements. Our study highlights the main positive effects of psychotropic medication and barriers to medication intake and adherence. Positive effects included symptom management and health improvement. Barriers varied from those directly linked to medication effects (e.g., negative side effects or lack of perceived effect) to personal barriers (e.g., forgetting to take medication or feelings of not being oneself due to medication intake) and societal barriers. In general, the barriers were reflected in concerns related to long-term consequences, such as medication dependence, and in concerns about diminished life prospects. Possible recommendations to improve the use of and adherence to psychotropic medication among adolescents include educating adolescents and parents not only about treatment options but also about mental disorders.

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Medication Adherence Among Adolescents with Bipolar Disorder

Cited by 21 publications

References 54 publications

Patient-physician discordance in assessment of adherence to inhaled controller medication: a cross-sectional analysis of two cohorts

Patient-physician discordance in assessment of adherence to inhaled controller medication: a cross-sectional analysis of two cohorts

Predicting Personalized Risk of Mood Recurrences in Youths and Young Adults With Bipolar Spectrum Disorder

Perceptions and Experiences of Adolescents with Mental Disorders and Their Parents about Psychotropic Medications in Turkey: A Qualitative Study

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