Montes Jose Manuel, Maurino Jorge, de Dios Consuelo, Medina Esteban
Department of Psychiatry, Hospital Universitario del Sureste.
Patient Prefer Adherence. 2013;7:89-94. doi: 10.2147/PPA.S39290. Epub 2013 Jan 18.
The primary aim of this study was to assess drug treatment adherence in patients with bipolar disorder and to identify factors associated with adherence. The secondary aim was to analyze the impact of suboptimal adherence on clinical and functional outcomes.
A cross-sectional study was conducted in a sample of outpatients receiving an oral antipsychotic drug. Medication adherence was assessed combining the 10-item Drug Attitude Inventory, the Morisky Green Adherence Questionnaire, and the Compliance Rating Scale. Logistic regression was used to determine significant variables associated with suboptimal adherence to medication.
Three hundred and three patients were enrolled into the study. The mean age was 45.9 ± 12.8 years, and 59.7% were females. Sixty-nine percent of patients showed suboptimal adherence. Disease severity and functioning were significantly worse in the suboptimal group than in the adherent group. Multivariate analysis showed depressive polarity of the last acute episode, presence of subsyndromal symptoms, and substance abuse/dependence to be significantly associated with suboptimal treatment adherence (odds ratios 3.41, 2.13, and 1.95, respectively).
A high prevalence of nonadherence was found in an outpatient sample with bipolar disorder. Identification of factors related to treatment adherence would give clinicians the opportunity to select more adequately patients who are eligible for potential adherence-focused interventions.
本研究的主要目的是评估双相情感障碍患者的药物治疗依从性，并确定与依从性相关的因素。次要目的是分析依从性欠佳对临床和功能结局的影响。
对接受口服抗精神病药物治疗的门诊患者样本进行了一项横断面研究。通过结合10项药物态度量表、莫里西-格林依从性问卷和依从性评定量表来评估药物依从性。采用逻辑回归分析来确定与药物治疗依从性欠佳相关的显著变量。
303名患者纳入本研究。平均年龄为45.9±12.8岁，59.7%为女性。69%的患者表现出依从性欠佳。依从性欠佳组的疾病严重程度和功能状况明显比依从组差。多变量分析显示，上一次急性发作的抑郁极性、亚综合征症状的存在以及药物滥用/依赖与治疗依从性欠佳显著相关（比值比分别为3.41、2.13和1.95）。
在双相情感障碍门诊患者样本中发现了较高的不依从率。识别与治疗依从性相关的因素将使临床医生有机会更充分地选择适合潜在依从性重点干预措施的患者。
