Trajectories of adherence to mood stabilizers in patients with bipolar disorder
Abstract Background Nonadherence with mood stabilizers is a major problem that negatively impacts the course of bipolar disorder. Medication adherence is a complex individual behavior, and adherence rates often change over time. This study asked if distinct classes of adherence trajectories with moo...
| Main Authors: | , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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SpringerOpen
2019-09-01
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| Series: | International Journal of Bipolar Disorders |
| Online Access: | http://link.springer.com/article/10.1186/s40345-019-0154-z |
| _version_ | 1819051389951672320 |
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| author | M. Bauer T. Glenn M. Alda R. Bauer P. Grof W. Marsh S. Monteith R. Munoz N. Rasgon K. Sagduyu P. C. Whybrow |
| author_facet | M. Bauer T. Glenn M. Alda R. Bauer P. Grof W. Marsh S. Monteith R. Munoz N. Rasgon K. Sagduyu P. C. Whybrow |
| author_sort | M. Bauer |
| collection | DOAJ |
| description | Abstract Background Nonadherence with mood stabilizers is a major problem that negatively impacts the course of bipolar disorder. Medication adherence is a complex individual behavior, and adherence rates often change over time. This study asked if distinct classes of adherence trajectories with mood stabilizers over time could be found, and if so, which patient characteristics were associated with the classes. Methods This analysis was based on 12 weeks of daily self-reported data from 273 patients with bipolar 1 or II disorder using ChronoRecord computer software. All patients were taking at least one mood stabilizer. The latent class mixed model was used to detect trajectories of adherence based on 12 weekly calculated adherence datapoints per patient. Results Two distinct trajectory classes were found: an adherent class (210 patients; 77%) and a less adherent class (63 patients; 23%). The characteristics associated with the less adherent class were: more time not euthymic (p < 0.001) and female gender (p = 0.016). No other demographic associations were found. Conclusion In a sample of motivated patients who complete daily mood charting, about one quarter were in the less adherent class. Even patients who actively participate in their care, such as by daily mood charting, may be nonadherent. Demographic characteristics may not be useful in assessing individual adherence. Future research on longitudinal adherence patterns in bipolar disorder is needed. |
| first_indexed | 2024-12-21T12:03:10Z |
| format | Article |
| id | doaj.art-c562f06d48854d7da6d8838506e82241 |
| institution | Directory Open Access Journal |
| issn | 2194-7511 |
| language | English |
| last_indexed | 2024-12-21T12:03:10Z |
| publishDate | 2019-09-01 |
| publisher | SpringerOpen |
| record_format | Article |
| series | International Journal of Bipolar Disorders |
| spelling | doaj.art-c562f06d48854d7da6d8838506e822412022-12-21T19:04:46ZengSpringerOpenInternational Journal of Bipolar Disorders2194-75112019-09-01711910.1186/s40345-019-0154-zTrajectories of adherence to mood stabilizers in patients with bipolar disorderM. Bauer0T. Glenn1M. Alda2R. Bauer3P. Grof4W. Marsh5S. Monteith6R. Munoz7N. Rasgon8K. Sagduyu9P. C. Whybrow10Department of Psychiatry and Psychotherapy, Medical Faculty, University Hospital Carl Gustav Carus, Technische Universität DresdenChronoRecord Association Inc.Department of Psychiatry, Dalhousie UniversityDepartment of Psychiatry and Psychotherapy, Medical Faculty, University Hospital Carl Gustav Carus, Technische Universität DresdenMood Disorders Center of Ottawa, University of TorontoDepartment of Psychiatry, University of MassachusettsMichigan State University College of Human MedicineDepartment of Psychiatry, University of California San DiegoDepartment of Psychiatry and Behavioral Sciences, Stanford School of MedicineDepartment of Psychiatry, University of Missouri Kansas City School of MedicineDepartment of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior University of California Los Angeles (UCLA)Abstract Background Nonadherence with mood stabilizers is a major problem that negatively impacts the course of bipolar disorder. Medication adherence is a complex individual behavior, and adherence rates often change over time. This study asked if distinct classes of adherence trajectories with mood stabilizers over time could be found, and if so, which patient characteristics were associated with the classes. Methods This analysis was based on 12 weeks of daily self-reported data from 273 patients with bipolar 1 or II disorder using ChronoRecord computer software. All patients were taking at least one mood stabilizer. The latent class mixed model was used to detect trajectories of adherence based on 12 weekly calculated adherence datapoints per patient. Results Two distinct trajectory classes were found: an adherent class (210 patients; 77%) and a less adherent class (63 patients; 23%). The characteristics associated with the less adherent class were: more time not euthymic (p < 0.001) and female gender (p = 0.016). No other demographic associations were found. Conclusion In a sample of motivated patients who complete daily mood charting, about one quarter were in the less adherent class. Even patients who actively participate in their care, such as by daily mood charting, may be nonadherent. Demographic characteristics may not be useful in assessing individual adherence. Future research on longitudinal adherence patterns in bipolar disorder is needed.http://link.springer.com/article/10.1186/s40345-019-0154-z |
| spellingShingle | M. Bauer T. Glenn M. Alda R. Bauer P. Grof W. Marsh S. Monteith R. Munoz N. Rasgon K. Sagduyu P. C. Whybrow Trajectories of adherence to mood stabilizers in patients with bipolar disorder International Journal of Bipolar Disorders |
| title | Trajectories of adherence to mood stabilizers in patients with bipolar disorder |
| title_full | Trajectories of adherence to mood stabilizers in patients with bipolar disorder |
| title_fullStr | Trajectories of adherence to mood stabilizers in patients with bipolar disorder |
| title_full_unstemmed | Trajectories of adherence to mood stabilizers in patients with bipolar disorder |
| title_short | Trajectories of adherence to mood stabilizers in patients with bipolar disorder |
| title_sort | trajectories of adherence to mood stabilizers in patients with bipolar disorder |
| url | http://link.springer.com/article/10.1186/s40345-019-0154-z |
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