Selvakumar Nivedhitha, Menon Vikas, Kattimani Shivan
Department of Psychiatry, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India.
Clin Psychopharmacol Neurosci. 2018 May 31;16(2):168-175. doi: 10.9758/cpn.2018.16.2.168.
Our objective was to determine patterns and predictors of medication adherence in bipolar disorder.
Between August 2015 and December 2016, we recruited 160 patients with a diagnosis of bipolar disorder as per International Classification of Diseases-10: Clinical Descriptions and Diagnostic Guidelines. The diagnosis was further confirmed by using the MINI International Neuropsychiatric Inventory. All of them were currently in remission (confirmed by standard measures) and on stable dosing of medication for at least a year. Medication adherence was assessed using Tamil validated version of Morisky Medication Adherence Scale. Patients were dichotomized into low adherence (<6) and high adherence (≥6) groups and compared on various socio-demographic and clinical variables.
Majority of the sample (n=97, 60.6%) demonstrated low adherence to treatment regimen. Being employed and having spent greater number of days in hospital were predictive of higher medication adherence (odds ratio [OR] 2.78, 95% confidence interval [CI] 1.019-7.585; and OR 1.02, 95% CI 1.003-1.037, respectively). Fewer number of lifetime depressive episodes and positive drug attitudes demonstrated trend level positive association with high medication adherence.
Non-adherence to prescribed medications is a common problem in bipolar disorder. Interventions targeting vocation, medication focused psychoeducation and promotion of positive drug attitudes are likely to enhance medication adherence in this group.
我们的目的是确定双相情感障碍患者药物依从性的模式和预测因素。
在2015年8月至2016年12月期间,我们根据《国际疾病分类第10版:临床描述与诊断指南》招募了160例双相情感障碍患者。通过使用MINI国际神经精神访谈进一步确诊。所有患者目前均处于缓解期(经标准测量确认)且药物剂量稳定至少一年。使用泰米尔语验证版的莫里西药物依从性量表评估药物依从性。将患者分为低依从性组(<6)和高依从性组(≥6),并比较各种社会人口统计学和临床变量。
大多数样本(n = 97,60.6%)对治疗方案的依从性较低。就业和住院天数较多可预测较高的药物依从性(优势比[OR]分别为2.78,95%置信区间[CI]为1.019 - 7.585;以及OR为1.02,95% CI为1.003 - 1.037)。终生抑郁发作次数较少和对药物持积极态度与高药物依从性呈趋势水平的正相关。
不遵医嘱服药是双相情感障碍中的一个常见问题。针对职业、以药物为重点的心理教育以及促进积极的药物态度的干预措施可能会提高该组患者的药物依从性。