Participation in decision-making about medication: A qualitative analysis of medication adherence
Open accessAbstract
Rates of relapse in BD are high with medication nonadherence identified as an important contributor to relapse. Psychopharmacology remains a key component to the treatment of BD; therefore, increased understanding of medication use and ways to promote greater adherence is essential. The aim of the study was to identify how participants with BD experience taking prescribed medication. Participants had BD I or BD II, were users of specialist mental health services, aged 18-64 years, euthymic, mildly hypomanic or depressed, and on any combination of medication. Exclusion criteria were minimal. A semistructured interview was completed exploring patients' views of BD and factors influencing adherence based on the Subjective Experience of Medication Interview. An inductive thematic analysis was used to identify themes. The study participants (n = 36) had predominantly bipolar I (78%) and were female (69%), and of New Zealand European ethnicity (67%) with 14% Maori. The mean age was 41 years (SD: 12.0). Findings from the thematic analysis generated three themes: Learning about the clinical meaning of having BD, Understanding how to use medication, and Understanding what works for me. The qualitative nature of our study limits the generalizability of our findings to a broader population of individuals with BD. The participants developed confidence in being in charge of their BD through a process of learning about BD and medication and understanding what this meant for them. The findings support greater emphasis on collaborative approaches that recognize the expertise of the individual with BD and the clinician.
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Commitment to treatment is a behavioral strategy explicitly oriented toward mental illness management.
“Commitment to treatment is a behavioral strategy explicitly oriented toward mental illness management [36,38,45,48,62,77].”
From Therapeutic Adherence of People with Mental Disorders: An Evolutionary Concept Analysis (2023) · cites this paper as [38]
Therapeutic adherence is described as a fluid process that reinforces collaborative approaches between the patient and the clinician and improves the relationship with professionals, affecting satisfaction with treatment.
“Some articles described therapeutic adherence as a fluid process that reinforces the collaborative approaches between the patient and the clinician [38,56,76] and improves the relationship with professionals [46], affecting satisfaction with treatment [34,45,62,77,78].”
From Therapeutic Adherence of People with Mental Disorders: An Evolutionary Concept Analysis (2023) · cites this paper as [38]
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Therapeutic Adherence of People with Mental Disorders: An Evolutionary Concept Analysis
Laranjeira, C., Carvalho, D., Valentim, O., Moutinho, L., Morgado, T., Tomás, C., Gomes, J., & Querido, A. (2023) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph20053869 · Cited by 45 · see citing works
- Authors
- Inder, M., Lacey, C., & Crowe, M.
- Affiliations
- University of Otago (NZ)
- Corresponding author
- Inder, Maree
- Lacey, Cameron
- Crowe, Marie
- Venue
- International Journal of Mental Health Nursing
- Publisher
- Wiley
- Published
- 2018-06-28
- Volume
- 28
- Issue
- 1
- Pages
- 181-189
- ISSN
- 1445-8330 (ISSN-L)
- 1447-0349
- OpenAlex
- W2810413859
- Cited by
- 16
- References
- 46
- Citations by year
- 2025: 1 · 2024: 3 · 2023: 1 · 2022: 3 · 2021: 3 · 2020: 3 · 2019: 2
- FWCI
- 1.56
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- International Journal of Mental Health Nursing (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Canterbury Medical Research Foundation
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Bipolar Disorder and Treatment
- Health Sciences › Medicine › Family Practice › Medication Adherence and Compliance
- Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
- Keywords
- bipolar disorder, medication adherence, patient involvement in treatment decisions, relapse, psychopharmacology, collaborative care, patient-clinician relationship
- MeSH terms
- Adult, Bipolar Disorder, Decision Making, Female, Humans, Male, Antipsychotic Agents, Qualitative Research, Medication Adherence
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