Factors That Affect Adherence to Bipolar Disorder Treatments: A Stated-Preference Approach
Abstract
BACKGROUND: Medication nonadherence is high among patients with bipolar disorder, and may lead to poor clinical outcomes, decreased quality of life, and increased resource utilization. OBJECTIVE: To investigate the factors associated with nonadherence and to assess the effect of patient-stated preferences on stated adherence to hypothetical medications. RESEARCH DESIGN: A choice-format stated-preference Web survey was administered. In each choice question, patients were asked to choose among 2 or 3 different hypothetical medications. Each choice question was followed by a question asking patients about their likely adherence to the selected medication alternative. SUBJECTS: Patients (N = 469) with self-reported bipolar disorder completed the survey which was programmed and administered to members of a chronic-illness Web panel. MEASURES: Factors associated with stated adherence to current treatment were identified. The effects of socioeconomic characteristics and medication attributes on stated adherence to hypothetical medications were assessed. RESULTS: Patient socioeconomic characteristics affect patients' adherence. Being white and having more education has a significant positive effect on adherence. Self-reported current adherence is a strong factor in predicting adherence for better medications. Medication outcome attributes, especially severity of depressive episodes, strongly influence patients' stated adherence to treatment. Weight gain and cognitive effects of a medication most significantly affected patients' likely adherence to medications for bipolar disorder. CONCLUSIONS: Patients are the final health care decision makers; their satisfaction with a medication is likely to affect whether or not they adhere to the medication prescribed by their physician. In the case of bipolar disorder, this study suggests patients are likely to be more adherent to medications that reduce the severity of depressive episodes and do not cause weight gain or cognitive side effects. By understanding the factors that improve adherence, health care providers can optimize prescribing patterns, which may ultimately lead to more effective management and improvement in the patient's condition.
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Psychiatric patients with lower education level (lower than secondary education) were more likely to be non-adherent to psychotropic medication compared to those with higher education level in six studies.
“In six studies, psychiatric patients having lower education level (lower than secondary education) were more likely to be non-adherent to their psychotropic medication compared to those patients having higher educational level [23, 40, 44, 52, 56, 57].”
From Psychotropic medication non-adherence and its associated factors among patients with major psychiatric disorders: A systematic review and meta-analysis (2020) · cites this paper as [44]
Sleepiness during day time (medication dose time) and potentially life-threatening or distressing side-effects seriously affected patients' medication non-adherence in two studies.
“In two studies, sleepiness during day time (medication dose time) and potentially life-threatening or distressing side-effects seriously affected patients’ medication non-adherence [37, 44].”
From Psychotropic medication non-adherence and its associated factors among patients with major psychiatric disorders: A systematic review and meta-analysis (2020) · cites this paper as [44]
Health care providers would be unable to explain and optimize prescribing pattern, timing, and dose benefit of medication; lack of friendly deal with medication complexity, tolerability, efficacy, and health belief issues were critical factors influencing medication adherence in three studies.
“In three studies, health care providers would be unable to explain and optimize prescribing pattern, timing, and dose benefit of medication. In addition, the lack of friendly deal with medication complexity, tolerability, efficacy, and health belief issues were critical factors influence medication adherence [11, 44, 52].”
From Psychotropic medication non-adherence and its associated factors among patients with major psychiatric disorders: A systematic review and meta-analysis (2020) · cites this paper as [44]
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- Authors
- Johnson, F. R., Özdemir, S., Manjunath, R., Hauber, A. B., Burch, S. P., & Thompson, T. R.
- Affiliations
- RTI Health Solutions (US)
- Corresponding author
- Johnson, F Reed
- Özdemir, Semra
- Venue
- Medical Care
- Published
- 2007-06
- Volume
- 45
- Issue
- 6
- Pages
- 545-552
- ISSN
- 0025-7079 (ISSN-L)
- OpenAlex
- W2005504722
- Cited by
- 164
- References
- 49
- Citations by year
- 2026: 3 · 2025: 10 · 2024: 5 · 2023: 21 · 2022: 8 · 2021: 9 · 2020: 10 · 2019: 6 · 2018: 6 · 2017: 8 · 2016: 11 · 2015: 8 · 2014: 12 · 2013: 8 · 2012: 2
- FWCI
- 7.71
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Medical Care (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Family Practice › Medication Adherence and Compliance
- Health Sciences › Medicine › Psychiatry and Mental health › Bipolar Disorder and Treatment
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Opioid Use Disorder Treatment
- Keywords
- bipolar disorder, medication adherence, treatment non-adherence, stated preference, discrete choice experiment, socioeconomic factors, depressive episode severity, weight gain, cognitive side effects, patient preferences, prescribing patterns
- MeSH terms
- Adult, Bipolar Disorder, Cognition Disorders, Decision Making, Female, Humans, Male, Middle Aged, Patient Compliance, Psychotropic Drugs, Surveys and Questionnaires, Socioeconomic Factors, Reproducibility of Results, Weight Gain, Multivariate Analysis, Patient Satisfaction
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