Key Factors ID'd for Bipolar Medication Nonadherence

Patients report side effects, beliefs, and knowledge about bipolar disorder are top reasons for not taking medications

THURSDAY, May 20, 2021 (HealthDay News) — Clinicians may underappreciate reasons why patients with bipolar disorder (BD) do not take their medicine, according to a review published online May 19 in Psychological Medicine.

Asta Ratna Prajapati, from the University of East Anglia in Norwich, England, and colleagues conducted a systematic literature review to identify studies reporting modifiable determinants of medication adherence in BD.

Based on 57 studies (32,894 participants), the researchers found that determinants reported by patients spanned 11 of the 14 theoretical domains framework (TDF) domains compared with six domains represented by clinician/researcher. The most commonly represented TDF domains included: environmental context and resources (63 percent; e.g., experiencing side effects); beliefs about consequences (63 percent; e.g., beliefs about medication effects); knowledge (40 percent; e.g., knowledge about disorder); social influences (33 percent; e.g., support from family/clinicians); memory, attention, and decision processes (33 percent; e.g., forgetfulness); emotion (21 percent; e.g., fear of addiction); and intentions (21 percent; e.g., wanting alternative treatment). The domains only reported by patients were intentions; memory, attention, and decision processes; and emotion.

“Clinicians may be underappreciating the full range of modifiable determinants of adherence and thus not providing adherence support reflective of patients’ needs,” the authors write.