Ralat Sandra I, Alicea-Cuprill Giselle, Arroyo Yashira, Otero William
Department of Psychiatry, Medical Sciences Campus, University of Puerto Rico, San Juan, PR 00936, USA.
Clinical Psychology Program, San Juan Campus, Albizu University, San Juan, PR 00901, USA.
J Clin Med. 2021 Dec 15;10(24):5890. doi: 10.3390/jcm10245890.
Nonadherence to treatment is a serious concern that affects the successful management of bipolar disorder (BD) patients. The aim of this study was to pilot test a psychosocial intervention (previously developed by this team) intended to increase adherence to medication and health behaviors targeting cardiovascular disease (CVD) risk factors in BD patients. An open, single-group design was used to assess the feasibility and acceptability of the intervention. The participants had BD, type I/II or unspecified, and CVD risk factors. Baseline demographic measures were taken. We also obtained preliminary effect sizes related to pre-post changes on measures of self-reported adherence to psychiatric medication, depressive and manic symptoms, and pharmacy records. At baseline, 29% of the participants reported recent adherence to psychiatric medications. A total of 71% of the participants completed the intervention. Pre-post improvements by medium and large effect sizes (Cohen's = 0.52-0.92) were seen in medication adherence, attitudes toward medication, and mania symptoms. The participants reported high levels of satisfaction with the intervention. A culturally sensitive psychosocial intervention for Puerto Rican BD patients who are at risk of CVD was found to be feasible and acceptable. Improvements in the key outcomes were seen in this small, preliminary study. Further research is needed with a larger sample size.
治疗依从性不佳是一个严重问题，影响着双相情感障碍（BD）患者的成功管理。本研究的目的是对一种心理社会干预措施（此前由本团队开发）进行试点测试，该干预旨在提高BD患者对药物治疗的依从性以及针对心血管疾病（CVD）风险因素的健康行为。采用开放、单组设计来评估该干预措施的可行性和可接受性。参与者患有I/II型或未明确类型的BD且存在CVD风险因素。记录了基线人口统计学指标。我们还获得了与自我报告的精神科药物依从性、抑郁和躁狂症状以及药房记录的前后变化相关的初步效应量。在基线时，29%的参与者报告近期坚持服用精神科药物。共有71%的参与者完成了干预。在药物依从性、对药物的态度和躁狂症状方面，观察到中等和大效应量（Cohen's = 0.52 - 0.92）的前后改善。参与者对该干预措施的满意度较高。对于有CVD风险的波多黎各BD患者，一种具有文化敏感性的心理社会干预措施被证明是可行且可接受的。在这项小型初步研究中观察到了关键结局的改善。需要更大样本量的进一步研究。
