Treatment adherence with antipsychotic medications in bipolar disorder.

Case Western Reserve University School of Medicine, Cleveland, OH, USA.
Bipolar Disorders (Impact Factor: 4.89). 07/2006; 8(3):232-41. DOI: 10.1111/j.1399-5618.2006.00314.x
Source: PubMed

ABSTRACT Atypical antipsychotic medications are a relatively new, increasingly prominent component of the treatment armamentarium for bipolar disorder. Information on adherence with antipsychotics among individuals with bipolar disorder in general, and atypical antipsychotics in particular, is currently quite limited. Using data from the VA National Psychosis Registry, we examined adherence with antipsychotic medications among patients with bipolar disorder (n = 73,964).
Antipsychotic medication adherence among veterans with bipolar disorder was evaluated using the medication possession ratio and categorizing patients into three groups: fully adherent, partially adherent and non-adherent. We compared characteristics of bipolar patients who received versus those who did not receive antipsychotic medication, and also identified predictors of poor adherence with antipsychotic medications.
Approximately 45% (n = 32,993) of all individuals with bipolar disorder were prescribed antipsychotic medication. Individuals who were prescribed antipsychotic medications were younger and more often had comorbid substance abuse or post-traumatic stress disorder compared to individuals with bipolar disorder who were not prescribed antipsychotic medication. Just over half (51.9%) of individuals appear to be fully adherent with antipsychotic medications, while 48.1% of individuals are either partially adherent or non-adherent with antipsychotic medications. Factors associated with treatment non-adherence were younger age, minority ethnicity, comorbid substance abuse and homelessness.
Treatment non-adherence is a major issue for close to half of individuals with bipolar disorder prescribed antipsychotic medication. Additional studies are needed to better understand treatment adherence within the full range of pharmacologic therapies among individuals with bipolar disorder.

  • [Show abstract] [Hide abstract]
    ABSTRACT: Little empirical research has directly examined the extent to which early and consistent participation in outpatient services and adherence to prescribed psychotropic medications after a psychiatric hospitalization can help people with serious mental illnesses avoid arrest and incarceration and what impact this might have on state and local costs. The authors examined effects of medication adherence in the first 90 days after a psychiatric hospitalization among 1,367 adults with schizophrenia or bipolar disorder served by the public behavioral health systems of Miami-Dade County and Pinellas County in Florida. Better adherence was associated with lower subsequent criminal justice costs and greater use of treatment services. A modest investment in promoting treatment participation and medication adherence may reduce criminal justice involvement and costs for persons with serious mental illness.
    Psychiatric services (Washington, D.C.) 10/2014; 65(10):1189-91. DOI:10.1176/ · 1.99 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Psychotropic medications are a common treatment for mental illness in people with developmental disabilities. Medication adherence is a critical determinant of the effectiveness of psychotropic drugs, but psychotropic medication adherence research specific to this population remains limited. This retrospective study analyzed Marketscan (R) Multi-State Medicaid Database 2003-2007 data. A total of 3,905 eligible community-based Medicaid enrollees aged 18-64 with dual diagnosis of developmental disability and mental illness were included and followed over an average of 510 days. Medication adherence was measured by Proportion of Days Covered (PDC), and logistic regression was used to assess factors associated with adherence. The mean PDC was 0.86, and the non-adherence rate was 25.7%. Factors associated with poor psychotropic medication adherence included minority race/ethnicity, female gender, enrollment in a Medicaid capitated plan, and having gastroesophageal reflux disease (GERD). Better psychotropic medication adherence was related to reductions in emergency room visits, suggesting better utilization outcomes.
    Journal of Mental Health Research in Intellectual Disabilities 10/2014; 8(1). DOI:10.1080/19315864.2014.959216
  • Journal of Experimental and Clinical Medicine 11/2014; DOI:10.1016/j.jecm.2014.10.008

Full-text (2 Sources)

Available from
Apr 7, 2015