Suboptimal treatment adherence in bipolar disorder: Impact on clinical outcomes and functioning

Department of Psychiatry, Hospital Universitario del Sureste.
Patient Preference and Adherence (Impact Factor: 1.68). 01/2013; 7:89-94. DOI: 10.2147/PPA.S39290
Source: PubMed


The primary aim of this study was to assess drug treatment adherence in patients with bipolar disorder and to identify factors associated with adherence. The secondary aim was to analyze the impact of suboptimal adherence on clinical and functional outcomes.
A cross-sectional study was conducted in a sample of outpatients receiving an oral antipsychotic drug. Medication adherence was assessed combining the 10-item Drug Attitude Inventory, the Morisky Green Adherence Questionnaire, and the Compliance Rating Scale. Logistic regression was used to determine significant variables associated with suboptimal adherence to medication.
Three hundred and three patients were enrolled into the study. The mean age was 45.9 ± 12.8 years, and 59.7% were females. Sixty-nine percent of patients showed suboptimal adherence. Disease severity and functioning were significantly worse in the suboptimal group than in the adherent group. Multivariate analysis showed depressive polarity of the last acute episode, presence of subsyndromal symptoms, and substance abuse/dependence to be significantly associated with suboptimal treatment adherence (odds ratios 3.41, 2.13, and 1.95, respectively).
A high prevalence of nonadherence was found in an outpatient sample with bipolar disorder. Identification of factors related to treatment adherence would give clinicians the opportunity to select more adequately patients who are eligible for potential adherence-focused interventions.

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Available from: Jorge Maurino, Jan 05, 2015
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    • "Treatment adherence in BD-II is a complex issue, with cases ranging from " selective " , " intermittent " , " late " , " abuse " , " full " or " behavioral " non-adherence depending on a broad number of factors (Colom et al., 2005). Sub-optimal TA has been reported in as much as 69.3% BD-II outpatients, with just 37% of whom being euthymic compared with 63.4% fully adherent samples (Montes et al., 2013). Also, higher levels of sensation seeking have already been reported to be associated with increased rates of TA À , independently on lifetime occurrence of SUD and to be substantially independent on psychotic symptoms (Liraud and Verdoux, 2001 ). "
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