A Cross-sectional Analysis of Patterns and Predictors of Medication Adherence in Bipolar Disorder: Single Center Experience from South India
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Objective: Our objective was to determine patterns and predictors of medication adherence in bipolar disorder. Methods: Between August 2015 and December 2016, we recruited 160 patients with a diagnosis of bipolar disorder as per International Classification of Diseases-10: Clinical Descriptions and Diagnostic Guidelines. The diagnosis was further confirmed by using the MINI International Neuropsychiatric Inventory. All of them were currently in remission (confirmed by standard measures) and on stable dosing of medication for at least a year. Medication adherence was assessed using Tamil validated version of Morisky Medication Adherence Scale. Patients were dichotomized into low adherence (<6) and high adherence (≥6) groups and compared on various socio-demographic and clinical variables. Results: Majority of the sample (n=97, 60.6%) demonstrated low adherence to treatment regimen. Being employed and having spent greater number of days in hospital were predictive of higher medication adherence (odds ratio [OR] 2.78, 95% confidence interval [CI] 1.019-7.585; and OR 1.02, 95% CI 1.003-1.037, respectively). Fewer number of lifetime depressive episodes and positive drug attitudes demonstrated trend level positive association with high medication adherence. Conclusion: Non-adherence to prescribed medications is a common problem in bipolar disorder. Interventions targeting vocation, medication focused psychoeducation and promotion of positive drug attitudes are likely to enhance medication adherence in this group.
Abstract
Objective: Our objective was to determine patterns and predictors of medication adherence in bipolar disorder. Methods: Between August 2015 and December 2016, we recruited 160 patients with a diagnosis of bipolar disorder as per International Classification of Diseases-10: Clinical Descriptions and Diagnostic Guidelines. The diagnosis was further confirmed by using the MINI International Neuropsychiatric Inventory. All of them were currently in remission (confirmed by standard measures) and on stable dosing of medication for at least a year. Medication adherence was assessed using Tamil validated version of Morisky Medication Adherence Scale. Patients were dichotomized into low adherence (<6) and high adherence (≥6) groups and compared on various socio-demographic and clinical variables. Results: Majority of the sample (n=97, 60.6%) demonstrated low adherence to treatment regimen. Being employed and having spent greater number of days in hospital were predictive of higher medication adherence (odds ratio [OR] 2.78, 95% confidence interval [CI] 1.019-7.585; and OR 1.02, 95% CI 1.003-1.037, respectively). Fewer number of lifetime depressive episodes and positive drug attitudes demonstrated trend level positive association with high medication adherence. Conclusion: Non-adherence to prescribed medications is a common problem in bipolar disorder. Interventions targeting vocation, medication focused psychoeducation and promotion of positive drug attitudes are likely to enhance medication adherence in this group.
참고문헌 (45)
- World Health Organization, "Adherence to long term therapy: evidence for action", WHO, ~ (2003)
- Byrne N, "Adherence to treatment in mood disorders", Curr Opin Psychiatry, 19, pp.44~49 (2006)[DOI]
- Ketter TA, "Nosology, diagnostic challenges, and unmet needs in managing bipolar disorder", J Clin Psychiatry, 71, pp.e27~ (2010)[DOI]
- Judd LL, "The long-term natural history of the weekly sympto-matic status of bipolar I disorder", Arch Gen Psychiatry, 59, pp.530~537 (2002)[DOI]
- Cramer JA, "Compliance with medication regimens for mental and physical disorders", Psychiatr Serv, 49, pp.196~201 (1998)[DOI]
- Belzeaux R, "Depressive residual symptoms are associated with lower adherence to medication in bipolar patients without substance use disorder: results from the FACE-BD cohort", J Affect Disord, 151, pp.1009~1015 (2013)[DOI]
- Lingam R, "Treatment non-adherence in affective disorders", Acta Psychiatr Scand, 105, pp.164~172 (2002)[DOI]
- Colom F, "Identifying and improving non-adherence in bipolar disorders", Bipolar Disord, 7(Suppl 5), pp.24~31 (2005)[DOI]
- Strakowski SM, "Twelve-month outcome after a first hospitalization for affective psychosis", Arch Gen Psychiatry, 55, pp.49~55 (1998)[DOI]
- Altman S, "Predictors of relapse in bipolar disorder: a review", J Psychiatr Pract, 12, pp.269~282 (2006)[DOI]
- Gonzalez-Pinto A, "Suicidal risk in bipolar I disorder patients and adherence to long-term lithium treatment", Bipolar Disord, 8, pp.618~624 (2006)[DOI]
- Schou M, "The combat of non-compliance during prophylactic lithium treatment", Acta Psychiatr Scand, 95, pp.361~363 (1997)[DOI]
- Scott J, "Using Health Belief Models to understand the efficacy-effectiveness gap for mood stabilizer treatments", Neuropsychobiology, 46(Suppl 1), pp.13~15 (2002)
- Baldessarini RJ, "Factors associated with treatment nonadherence among US bipolar disorder patients", Hum Psychopharmacol, 23, pp.95~105 (2008)[DOI]
- Sajatovic M, "Self-reported medication treatment adherence among veterans with bipolar disorder", Psychiatr Serv, 57, pp.56~62 (2006)[DOI]
- Scott J, "Nonadherence with mood stabilizers: prevalence and predictors", J Clin Psychiatry, 63, pp.384~390 (2002)[DOI]
- Johnson FR, "Factors that affect adherence to bipolar disorder treatments: a stated-preference approach", Med Care, 45, pp.545~552 (2007)[DOI]
- Jimmy B, "Patient medication adherence: measures in daily practice", Oman Med J, 26, pp.155~159 (2011)[DOI]
- Haynes RB, "Physicians' and patients' choices in evidence based practice", BMJ, 324, pp.1350~ (2002)[DOI]
- Haynes RB, "Systematic review of randomised trials of interventions to assist patients to follow prescriptions for medications", Lancet, 348, pp.383~386 (1996)[DOI]
- World Health Organization, "The ICD-10 classification of mental and behavioural disorders: clinical description and diagnostic guidelines", WHO, ~ (1992)
- Sheehan DV, "The Mini-International Neuropsychiatric Interview (M.I.N.I.): the development and validation of a structured diagnostic psychiatric interview for DSM-IV and ICD-10", J Clin Psychiatry, 59(Suppl 20), pp.22~33 (1998)
- Hamilton M, "A rating scale for depression", J Neurol Neurosurg Psychiatry, 23, pp.56~62 (1960)[DOI]
- Young RC, "A rating scale for mania: reliability, validity and sensitivity", Br J Psychiatry, 133, pp.429~435 (1978)[DOI]
- Morisky DE, "Predictive validity of a medication adherence measure in an outpatient setting", J Clin Hypertens (Greenwich), 10, pp.348~354 (2008)[DOI]
- Morisky DE, "Concurrent and predictive validity of a self-reported measure of medication adherence", Med Care, 24, pp.67~74 (1986)[DOI]
- Lam WY, "Medication adherence measures: an overview", Biomed Res Int, 2015, pp.217047~ (2015)
- Bates JA, "Correlates of medication adherence among patients with bipolar disorder: results of the bipolar evaluation of satisfaction and tolerability (BEST) study: a nationwide cross-sectional survey", Prim Care Companion J Clin Psychiatry, 12 (2010)
- Hogan T, "Handbook of psychiatric measures" (2000), American Psychiatric Association Publishing
- Hogan TP, "A self-report scale predictive of drug compliance in schizophrenics: reliability and discriminative validity", Psychol Med, 13, pp.177~183 (1983)[DOI]
- Sajatovic M, "Treatment adherence with lithium and anticonvulsant medications among patients with bipolar disorder", Psychiatr Serv, 58, pp.855~863 (2007)[DOI]
- Sajatovic M, "Treatment adherence with antipsychotic medications in bipolar disorder", Bipolar Disord, 8, pp.232~241 (2006)[DOI]
- Perlick DA, "Medication non-adherence in bipolar disorder: A patient-centered review of research findings", Clin Approaches Bipolar Disord, 3, pp.56~64 (2004)
- Kutzelnigg A, "Compliance as a stable function in the treatment course of bipolar disorder in patients stabilized on olanzapine: results from a 24-month observational study", Int J Bipolar Disord, 2, pp.13~ (2014)[DOI]
- Teter CJ, "Medication adherence and attitudes in patients with bipolar disorder and current versus past substance use disorder", Psychiatry Res, 190, pp.253~258 (2011)[DOI]
- Lan-Ting Lee, "Holistic Consideration of Patients with Schizophrenia to Improve Medication Adherence and Outcomes", Clinical Psychopharmacology and Neuroscience, 13(2), pp.138~143 (2015), 대한정신약물학회
- Perlis RH, "Clinical features associated with poor pharmacologic adherence in bipolar disorder: results from the STEP-BD study", J Clin Psychiatry, 71, pp.296~303 (2010)[DOI]
- Keck PE Jr, "Compliance with maintenance treatment in bipolar disorder", Psychopharmacol Bull, 33, pp.87~91 (1997)
- Weiss RD, "Does recovery from substance use disorder matter in patients with bipolar disorder?", J Clin Psychiatry, 66, pp.730~735 (2005)[DOI]
- Keck PE Jr, "Factors associated with pharmacologic noncompliance in patients with mania", J Clin Psychiatry, 57, pp.292~297 (1996)
- Weiss RD, "Medication compliance among patients with bipolar disorder and substance use disorder", J Clin Psychiatry, 59, pp.172~174 (1998)[DOI]
- Chandra IS, "Attitudes toward medication and reasons for non-compliance in patients with schizophrenia", Indian J Psychol Med, 36, pp.294~298 (2014)[DOI]
- Hall AK, "Mobile text messaging for health: a systematic review of reviews", Annu Rev Public Health, 36, pp.393~415 (2015)[DOI]
- Ershad Sarabi R, "The effectiveness of mobile phone text messaging in improving medication adherence for patients with chronic diseases: a systematic review", Iran Red Crescent Med J, 18, pp.e25183~ (2016)
- El-Mallakh P, "Strategies to improve medication adherence in patients with schizophrenia: the role of support services", Neuropsychiatr Dis Treat, 11, pp.1077~1090 (2015)
