Clinical Features Associated With Poor Pharmacologic Adherence in Bipolar Disorder
- 15 March 2010
- journal article
- research article
- Published by Physicians Postgraduate Press, Inc in British Journal of Psychology
- Vol. 71 (03), 296-303
- https://doi.org/10.4088/jcp.09m05514yel
Abstract
Poor medication adherence is common among bipolar patients. We examined prospective data from 2 cohorts of individuals from the Systematic Treatment Enhancement Program for Bipolar Disorder (STEP-BD) study (1999–2005) with bipolar disorder. Clinical and sociodemographic features associated with missing at least 25% of doses of at least 1 medication were assessed using logistic regression, and a risk stratification model was developed and validated. Of 3,640 subjects with 48,287 follow-up visits, 871 (24%) reported nonadherence on 20% or more study visits. Clinical features significantly associated (P < .05) with poor adherence included rapid cycling, suicide attempts, earlier onset of illness, and current anxiety or alcohol use disorder. Nonadherence during the first 3 months of follow-up was associated with less improvement in functioning at 12-month follow-up (P < .03). A risk stratification model using clinical predictors accurately classified 80.6% of visits in an independent validation cohort. Risk for poor medication adherence can be estimated and may be useful in targeting interventions.Keywords
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