Customized adherence enhancement for individuals with bipolar disorder receiving antipsychotic therapy.
OBJECTIVE
A three-month prospective trial of a psychosocial intervention--customized adherence enhancement (CAE)--was conducted with 43 medication-nonadherent individuals with bipolar disorder.


METHODS
CAE modules were administered as indicated by a screen that identifies reasons for nonadherence. The primary outcome was change in adherence to mood-stabilizing medications as measured by the Tablet Routines Questionnaire and pill counts. Secondary outcomes included change in symptoms, measured by the Hamilton Rating Scale for Depression (HAM-D), Young Mania Rating Scale (YMRS), and Brief Psychiatric Rating Scale (BPRS).


RESULTS
Participants completed 76% of sessions. Dropout at three months was 13 (30%). Adherence improved from a baseline mean±SD of 34%±27% of tablets missed in the past month to only 10%±15% (p<.001). BPRS, HAM-D, andYMRS scores all indicated significant improvement at three-month follow-up (p<.05).


CONCLUSIONS
Although conclusions must be tempered by the uncontrolled design, CAE appeared to be well accepted and was associated with improvements in adherence, symptoms, and functioning.
Department of Psychiatry, Case Western Reserve University, 10524 Euclid Ave., Cleveland, OH 44106, USA. martha.sajatovic@uhhs.com
Martha
M
Sajatovic
Jennifer
J
Levin
Curtis
C
Tatsuoka
Weronika
W
Micula-Gondek
Tiffany D
TD
Williams
Christopher S
CS
Bialko
Kristin A
KA
Cassidy
D000328:Adult; D014150:Antipsychotic Agents / Q000627:therapeutic use*; D001714:Bipolar Disorder / Q000188:drug therapy* / Q000523:psychology; D005260:Female; D006801:Humans; D057194:Intention to Treat Analysis; D008297:Male; D055118:Medication Adherence / Q000523:psychology; D008875:Middle Aged; D010352:Patient Dropouts / Q000706:statistics & numerical data; D010353:Patient Education as Topic; D011446:Prospective Studies; D011569:Psychiatric Status Rating Scales; D016903:Drug Monitoring
D014150:Antipsychotic Agents