High bipolar medication adherence not elusive

By Lucy Piper, Senior medwireNews Reporter

Researchers have found “remarkably” high medication adherence rates among patients with bipolar disorder participating in a comparative effectiveness trial.

The rate of adherence was greater than 93% over the duration of the 6-month study: just 4.5% of patients reported missing at least 30% of their medications in the past week at baseline as did 6.45% at week 12 and 6.72% at week 24.

“Given the high rates of adherence, we did not find any group differences on demographic or clinical features, but we did find that medication adherence was associated with improved course of illness,” comments the team led by Louisa Sylvia (Massachusetts General Hospital, Boston, USA) in Acta Psychiatrica Scandinavica.

Patients were more likely to report missed medication doses on the Tablet Routine Questionnaire if they had more manic symptoms on the Young Mania Rating Scale and side effects on the Frequency and Intensity of Side Effects Ratings. There was no association with poor quality of life, overall severity of illness, or depressive symptoms.

But the researchers note that within-subject self-reported adherence was quite variable over time, with no consistent pattern of endorsed adherence.

A total of 283 patients with bipolar disorder participated in the trial and were taking optimized treatment or optimized treatment with adjunctive dose moderate mood stabilizer.

The fact that the patients were willingly participating in a treatment trial may have contributed to the high adherence rate, note Sylvia et al, although they add that the rates are still substantially higher than those in other bipolar pharmacologic studies.

As some of the patients were still not taking their medications despite participating in a closely monitored clinical trial, the researchers say their data “highlight the need to further elucidate who tends to adhere to their medications, or perhaps more importantly, who does not tend to adhere, given that adherence may buffer against future bipolar episodes.”

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