Clatworthy Jane, Bowskill Richard, Rank Tim, Parham Rhian, Horne Rob
Centre for Behavioural Medicine, School of Pharmacy, University of London, London, UK.
Bipolar Disord. 2007 Sep;9(6):656-64. doi: 10.1111/j.1399-5618.2007.00434.x.
Patients' perceptions of illness and treatment have been found to predict adherence to medication in many chronic conditions. This has not yet been fully explored in bipolar disorder (BD). The aim was to use a qualitative methodology to explore in depth the beliefs about BD and its treatment that are associated with adherence to medication prescribed for BD.
Sixteen adults prescribed prophylactic treatment for BD completed semi-structured interviews about their perceptions of BD and its treatment and their adherence to medication. Interviews were recorded and transcribed verbatim. Two researchers identified perceptions associated with non-adherence in the transcripts.
Thirteen participants (81%) reported some degree of intentional or unintentional medication non-adherence. Intentional non-adherence was associated with patients' concerns about the prescribed medication, arising from the experience of side effects, but also from beliefs that regular use could lead to adverse effects in the future. Intentional non-adherence was also associated with doubts about the personal need for medication, which were related to perceptions of BD (e.g., not accepting diagnosis, believing the condition is not controllable, believing it is not a chronic condition).
This study has identified some of the salient beliefs about BD and its treatment that should be elicited and addressed in interventions to facilitate adherence to medication. Further quantitative work is justified to explore the utility of this approach in the development of interventions.
在许多慢性疾病中，患者对疾病和治疗的认知已被发现可预测其对药物治疗的依从性。双相情感障碍（BD）方面尚未对此进行充分研究。本研究旨在运用定性研究方法，深入探究与BD药物治疗依从性相关的对BD及其治疗的认知。
16名接受BD预防性治疗的成年人完成了关于他们对BD及其治疗的认知以及药物治疗依从性的半结构化访谈。访谈进行了录音并逐字转录。两名研究人员在转录文本中确定了与不依从相关的认知。
13名参与者（81%）报告存在某种程度的有意或无意的药物不依从情况。有意不依从与患者对所开药物的担忧有关，这种担忧源于副作用经历，也源于认为长期使用可能在未来导致不良影响的观念。有意不依从还与对个人用药需求的怀疑有关，这与对BD的认知相关（例如不接受诊断、认为病情不可控制、认为不是慢性病）。
本研究确定了一些关于BD及其治疗的显著认知，在促进药物治疗依从性的干预措施中应引出并解决这些认知。有必要开展进一步的定量研究，以探索这种方法在干预措施开发中的效用。
