title: Adherence to Psychotropic and Nonpsychotropic Medication Among Patients With Bipolar Disorder and General Medical Conditions.
abstract: OBJECTIVE
  This study assessed the relationship between nonadherence to psychotropic and nonpsychotropic medications for 88 patients nonadherent to medication treatment for bipolar disorder.
  
  
  METHODS
  This descriptive study was part of a clinical trial promoting medication adherence. Nonadherence was defined as ≥ 20% of days with missed doses.
  
  
  RESULTS
  A majority of the sample was female and had type I bipolar disorder; 49% had hypertension, 39% had hyperlipidemia, and 69% smoked; average body mass index was 34, and 65% were obese. The median proportion of days with missed doses was 53.6% (interquartile ratio [IQR]=38.10%-73.40%) for psychotropic medications and 33.93% (IQR=13.81%-51.91%) for nonpsychotropic medications. There was a significant difference between nonadherence to psychotropic and nonpsychotropic medication for the past week (z=-4.11, p<.001) and past month (z=-4.19, p<.001). More global psychopathology was associated with nonpsychotropic nonadherence.
  
  
  CONCLUSIONS
  Psychotropic adherence was worse than nonpsychotropic adherence, yet both were poor. Improving adherence to cardiovascular medications is a reasonable pathway to improve cardiovascular health in this population.
authors.affiliation: Dr. Levin and Dr. Sajatovic are with the Department of Psychiatry and Dr. Tatsuoka is with the Department of Neurology, Case Western Reserve University School of Medicine, Cleveland, Ohio (e-mail: jennifer.levin@uhhospitals.org ). Dr. Levin, Dr. Tatsuoka, and Dr. Sajatovic are also with the Neurological and Behavioral Outcomes Center, University Hospitals Case Medical Center, Cleveland, where Ms. Aebi and Ms. Cassidy are with the Department of Psychiatry.
authors.forename: Jennifer B
authors.initials: JB
authors.lastname: Levin
authors.affiliation: Dr. Levin and Dr. Sajatovic are with the Department of Psychiatry and Dr. Tatsuoka is with the Department of Neurology, Case Western Reserve University School of Medicine, Cleveland, Ohio (e-mail: jennifer.levin@uhhospitals.org ). Dr. Levin, Dr. Tatsuoka, and Dr. Sajatovic are also with the Neurological and Behavioral Outcomes Center, University Hospitals Case Medical Center, Cleveland, where Ms. Aebi and Ms. Cassidy are with the Department of Psychiatry.
authors.forename: Michelle E
authors.initials: ME
authors.lastname: Aebi
authors.affiliation: Dr. Levin and Dr. Sajatovic are with the Department of Psychiatry and Dr. Tatsuoka is with the Department of Neurology, Case Western Reserve University School of Medicine, Cleveland, Ohio (e-mail: jennifer.levin@uhhospitals.org ). Dr. Levin, Dr. Tatsuoka, and Dr. Sajatovic are also with the Neurological and Behavioral Outcomes Center, University Hospitals Case Medical Center, Cleveland, where Ms. Aebi and Ms. Cassidy are with the Department of Psychiatry.
authors.forename: Curtis
authors.initials: C
authors.lastname: Tatsuoka
authors.affiliation: Dr. Levin and Dr. Sajatovic are with the Department of Psychiatry and Dr. Tatsuoka is with the Department of Neurology, Case Western Reserve University School of Medicine, Cleveland, Ohio (e-mail: jennifer.levin@uhhospitals.org ). Dr. Levin, Dr. Tatsuoka, and Dr. Sajatovic are also with the Neurological and Behavioral Outcomes Center, University Hospitals Case Medical Center, Cleveland, where Ms. Aebi and Ms. Cassidy are with the Department of Psychiatry.
authors.forename: Kristin A
authors.initials: KA
authors.lastname: Cassidy
authors.affiliation: Dr. Levin and Dr. Sajatovic are with the Department of Psychiatry and Dr. Tatsuoka is with the Department of Neurology, Case Western Reserve University School of Medicine, Cleveland, Ohio (e-mail: jennifer.levin@uhhospitals.org ). Dr. Levin, Dr. Tatsuoka, and Dr. Sajatovic are also with the Neurological and Behavioral Outcomes Center, University Hospitals Case Medical Center, Cleveland, where Ms. Aebi and Ms. Cassidy are with the Department of Psychiatry.
authors.forename: Martha
authors.initials: M
authors.lastname: Sajatovic
mesh_terms: D000328:Adult; D001714:Bipolar Disorder / Q000150:complications* / Q000188:drug therapy*; D005260:Female; D006801:Humans; D006949:Hyperlipidemias / Q000453:epidemiology; D006973:Hypertension / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D011619:Psychotropic Drugs / Q000627:therapeutic use*; D057566:Self Report; D012907:Smoking / Q000453:epidemiology; D014481:United States; D016903:Drug Monitoring
chemical_list: D011619:Psychotropic Drugs