Clin Psychopharmacol Neurosci.  2018 May;16(2):168-175. 10.9758/cpn.2018.16.2.168.

A Cross-sectional Analysis of Patterns and Predictors of Medication Adherence in Bipolar Disorder: Single Center Experience from South India

Affiliations
  • 1Department of Psychiatry, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India. drvmenon@gmail.com

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.

Keyword

Bipolar disorder; Medication adherence; Medication compliance; Medication persistence; Therapeutics; Psychiatry
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