Association Between Symptom Severity and Medication Adherence in Adults with Bipolar Disorder Reporting Adherence Challenges.

Humans Bipolar Disorder / drug therapy Female Medication Adherence / statistics & numerical data Male Adult Middle Aged Severity of Illness Index Self Report Surveys and Questionnaires Psychiatric Status Rating Scales
bipolar disorder depression mania manic depressive disorder medication adherence

Journal

Psychopharmacology bulletin
ISSN: 2472-2448
Titre abrégé: Psychopharmacol Bull
Pays: United States
ID NLM: 0101123

Informations de publication

Date de publication:
08 Jul 2024
Historique:
pmc-release: 08 07 2025
medline: 12 7 2024
pubmed: 12 7 2024
entrez: 12 7 2024
Statut: ppublish

Résumé

Given the importance of medication adherence among individuals with bipolar disorder (BD), this analysis from an ongoing randomized controlled trial (RCT) examined the relationship between BD symptoms, functioning and adherence in 69 poorly adherent adults with BD. Study inclusion criteria included being ≥ 18 years old with BD Type 1 or 2, difficulties with medication adherence and actively symptomatic as measured by Brief Psychiatric Rating Scale (BPRS) score ≥ 36, Young Mania Rating Scale (YMRS) > 8 or Montgomery Asberg Depression Rating Scale (MADRS) > 8. Adherence was measured in 2 ways: 1) the self-reported Tablets Routine Questionnaire (TRQ) and 2) electronic pill container monitoring (eCap pillbox). BD symptoms and functioning were measured with the MADRS, YMRS, Clinical Global Impressions Scale (CGI), and Global Assessment of Functioning (GAF). Only screening and baseline data were examined. Mean age was 42.32 (SD = 12.99) years, with 72.46% (n = 50) female and 43.48% (n = 30) non-white. Mean past 7-day percentage of days with missed BD medications using TRQ was 40.63% (SD = 32.61) and 30.30% (SD = 30.41) at screening and baseline, respectively. Baseline adherence using eCap was 42.16% (SD = 35.85) in those with available eCap data (n = 41). Worse adherence based on TRQ was significantly associated with higher MADRS (p = 0.04) and CGI (p = .03) but lower GAF (p = 0.02). eCAP measured adherence was not significantly associated with clinical variables. While depression and functioning were approximate markers of adherence, reliance on patient self-report or BD symptom presentation may give an incomplete picture of medication-taking behaviors.

Sections du résumé

Background UNASSIGNED
Given the importance of medication adherence among individuals with bipolar disorder (BD), this analysis from an ongoing randomized controlled trial (RCT) examined the relationship between BD symptoms, functioning and adherence in 69 poorly adherent adults with BD.
Method UNASSIGNED
Study inclusion criteria included being ≥ 18 years old with BD Type 1 or 2, difficulties with medication adherence and actively symptomatic as measured by Brief Psychiatric Rating Scale (BPRS) score ≥ 36, Young Mania Rating Scale (YMRS) > 8 or Montgomery Asberg Depression Rating Scale (MADRS) > 8. Adherence was measured in 2 ways: 1) the self-reported Tablets Routine Questionnaire (TRQ) and 2) electronic pill container monitoring (eCap pillbox). BD symptoms and functioning were measured with the MADRS, YMRS, Clinical Global Impressions Scale (CGI), and Global Assessment of Functioning (GAF). Only screening and baseline data were examined.
Results UNASSIGNED
Mean age was 42.32 (SD = 12.99) years, with 72.46% (n = 50) female and 43.48% (n = 30) non-white. Mean past 7-day percentage of days with missed BD medications using TRQ was 40.63% (SD = 32.61) and 30.30% (SD = 30.41) at screening and baseline, respectively. Baseline adherence using eCap was 42.16% (SD = 35.85) in those with available eCap data (n = 41). Worse adherence based on TRQ was significantly associated with higher MADRS (p = 0.04) and CGI (p = .03) but lower GAF (p = 0.02). eCAP measured adherence was not significantly associated with clinical variables.
Conclusion UNASSIGNED
While depression and functioning were approximate markers of adherence, reliance on patient self-report or BD symptom presentation may give an incomplete picture of medication-taking behaviors.

Identifiants

PMID: 38993661 PMC: PMC11235580
pubmed: 38993661
pmc: PMC11235580

Types de publication

Journal Article Randomized Controlled Trial

Langues

eng

Sous-ensembles de citation

IM

Pagination

60-72

Informations de copyright

Copyright © 1964–2024 by MedWorks Media Inc, Los Angeles, CA All rights reserved. Printed in the United States.

Auteurs

Martha Sajatovic (M)

Sajatovic, MD, Department of Psychiatry, Case Western Reserve University School of Medicine, Cleveland, OH, USA; Neurological and Behavioral Outcomes Center, University Hospitals Cleveland Medical Center, Cleveland, OH, USA; Department of Psychiatry, University Hospitals Cleveland Medical Center, Cleveland, OH, USA.

Farren Briggs (F)

Briggs, PhD, Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL, USA.

Clara Adeniyi (C)

Adeniyi, Department of Psychiatry, Case Western Reserve University School of Medicine, Cleveland, OH, USA.

Jacob Koopman (J)

Koopman, Department of Psychiatry, Case Western Reserve University School of Medicine, Cleveland, OH, USA.

Jessica Black (J)

Black, Department of Psychiatry, Case Western Reserve University School of Medicine, Cleveland, OH, USA.

Celeste Weise (C)

Weise, Department of Psychiatry, Case Western Reserve University School of Medicine, Cleveland, OH, USA.

Nicole Fiorelli (N)

Fiorelli, Department of Psychiatry, Case Western Reserve University School of Medicine, Cleveland, OH, USA.

Joy Yala (J)

Yala, Department of Psychiatry, Case Western Reserve University School of Medicine, Cleveland, OH, USA.

Mohammad Lesanpezeshki (M)

Lesanpezeshki, Department of Psychiatry, MetroHealth System, Cleveland, OH, USA.

Douglas Einstadter (D)

Einstadter, Center for Health Care Research and Policy, MetroHealth System, Cleveland, OH, USA; Departments of Medicine and Population and Quantitative Health Sciences, Case Western Reserve University School of Medicine, Cleveland, OH, USA.

Jennifer B Levin (JB)

Levin, PhD, Department of Psychiatry, Case Western Reserve University School of Medicine, Cleveland, OH, USA; Neurological and Behavioral Outcomes Center, University Hospitals Cleveland Medical Center, Cleveland, OH, USA; Department of Psychiatry, University Hospitals Cleveland Medical Center, Cleveland, OH, USA.

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