Department of Psychological Medicine, University of Otago, PO Box 4345, Christchurch, New Zealand.
Int J Nurs Stud. 2011 Jul;48(7):894-903. doi: 10.1016/j.ijnurstu.2011.03.008. Epub 2011 Apr 9.
As with other long-term conditions patients with bipolar disorder are rarely totally adherent or non-adherent. Rates of non-adherence have not changed since the first introduction of psychotropic medications in the 1950s despite vast numbers of new compounds being marketed. Non-adherence with medication in bipolar disorder is associated with affective relapse and consequently poor quality of life. The reasons that patients are non-adherent with medication are not well understood by clinicians who often assume it is related to the illness itself.
To identify patients' perceptions of medication adherence in bipolar disorder.
An integrated review of the literature published between 1999 and 2010.
Ovid (Medline, CINAHL, Embase, PsycINFO) and manual searching.
An integrative review of the literature was conducted which included: (a) problem formation, (b) literature search and initial screening, (c) gathering data from studies, (d) evaluating study quality, (e) data analysis and integration, (f) data interpretation, and (g) presentation of the findings.
Thirteen articles met criteria for inclusion in the review. These articles identified how patients reported their perceptions on medication and were integrated into four categories: illness factors, personal attitudes and beliefs, medication factors and environmental factors.
These findings suggest a need to address adherence from the full range of influencing factors (patient, illness, medication and environmental). Clinicians need to utilise a collaborative approach to working together with patients in order to identify the meaning that patients attribute to the symptoms, diagnosis, prognosis and medication. Understanding patients' perceptions and accepting these may facilitate greater medication adherence and the consequent improved clinical outcomes for patients with bipolar disorder.
与其他长期疾病一样，双相情感障碍患者很少完全依从或不依从。尽管有大量新化合物上市，但自 20 世纪 50 年代首次引入精神药物以来，不依从率并未改变。在双相情感障碍中，药物不依从与情感复发有关，因此生活质量较差。临床医生对患者不依从药物的原因了解甚少，他们通常认为这与疾病本身有关。
确定双相情感障碍患者对药物依从性的看法。
对 1999 年至 2010 年期间发表的文献进行综合回顾。
Ovid（Medline、CINAHL、Embase、PsycINFO）和手动搜索。
对文献进行综合回顾，包括：（a）问题形成，（b）文献搜索和初步筛选，（c）从研究中收集数据，（d）评估研究质量，（e）数据分析和整合，（f）数据解释，（g）呈现研究结果。
符合纳入标准的文章有 13 篇。这些文章确定了患者如何报告他们对药物的看法，并将其整合为四个类别：疾病因素、个人态度和信念、药物因素和环境因素。
这些发现表明需要从全面的影响因素（患者、疾病、药物和环境）来解决依从性问题。临床医生需要采用协作的方法与患者合作，以确定患者对症状、诊断、预后和药物的理解。了解患者的看法并接受这些看法可能会促进患者对双相情感障碍药物的更大依从性，并带来更好的临床结果。
