Real-World Treatment Patterns and Adherence to Oral Medication Among Patients with Bipolar Disorders: A Retrospective, Observational Study Using a Healthcare Claims Database.

This study aimed to describe real-world treatment patterns and medication adherence among patients with bipolar disorder (BD) in Japan. Adult patients with a BD diagnosis were identified between July 2013 and February 2018, using an employment-based health insurance claims database from the JMDC Inc. Treatment patterns of target drugs (mood stabilizers, antipsychotics) and adherence (measured by the proportion of days covered [PDC]) were assessed during the first- through third-year follow-up. Adherence was also assessed for patient subgroups. The analyzed population included 13,788 patients with BD. They were mostly prescribed sodium valproate, lithium, or aripiprazole (range: 21.1-27.4%) across 3 years of follow-up, whereas lamotrigine was prescribed to 11.2-12.8% of patients. Benzodiazepines (70-87%) and antidepressants (52-71%) were commonly prescribed during all three follow-up periods. The mean PDC among all patients with BD was 0.51 during the first and increased to 0.61 during the third year. The mean PDC was 0.42 (first year) in patients aged <30 years and 0.49 in those aged 30-40 years. The PDC was 0.44-0.61 (depending on the drug class) in those who were prescribed a single-class target drug and 0.68-0.83 in those prescribed two drug classes concomitantly. This study documented generally low medication adherence among patients with BD, and those at young age. These patients may require more attention.

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© 2021 Inoue et al.

Déclaration de conflit d'intérêts

TI has received the following: personal fees from Mochida Pharmaceutical, Takeda Pharmaceutical, Eli Lilly, Janssen Pharmaceutical, MSD, Taisho Toyama Pharmaceutical, Yoshitomiyakuhin, and Daiichi Sankyo; grants from Shionogi, Astellas, Tsumura, and Eisai; and grants and personal fees from Otsuka Pharmaceutical Co. Ltd., Dainippon Sumitomo Pharma, Mitsubishi Tanabe Pharma, Kyowa Pharmaceutical Industry, Pfizer, Novartis Pharma, and Meiji Seika Pharma. TI is a member of the advisory boards of Pfizer, Novartis Pharma, and Mitsubishi Tanabe Pharma. OS has received speakers’ honoraria from Eli Lilly Japan, Otsuka Pharmaceutical Co. Ltd., Otsuka Pharmaceutical Factory, Meiji Seika Pharma, Kyowa Pharmaceutical Industry, Pfizer Japan, Sumitomo Dainippon Pharma, Yoshitomiyakuhin, Alfresa Pharma, Eisai, and MSD. HS, YK, and SY are employees of Otsuka Pharmaceutical Co., Ltd., Japan. The authors report no other conflicts of interest in this work.