title: Medication Adherence Among Adolescents with Bipolar Disorder.
abstract: To examine medication adherence and associated factors among adolescents with bipolar disorder (BP) using both objective and subjective methods.
  
  
  
  Participants were 21 adolescents with a primary BP diagnosis recruited from a pediatric specialty clinic. All participants were prescribed at least one psychotropic medication. Self- and parent-reported adherence were assessed monthly over 6 months. Objective data on medication adherence were gathered through an electronic weekly pillbox. Demographic and clinical factors were assessed through self, parent, and physician ratings at baseline, 3, and 6 months.
  
  
  
  Objective data indicate 41.5% of doses (58.6% of days) were not taken as prescribed over a mean of 3 months of follow-up. Subjective reports (patient, parent, and physician) significantly overestimated adherence as compared with objective data. Factors from multiple domains were associated with poorer adherence, including more daily doses, higher weight, dose timing (poorer on mornings/afternoons and weekends), less temporal proximity to medication management appointment, greater self-reported cognitive difficulties with adhering to treatment; the most potent predictor of missed doses was greater overall illness severity.
  
  
  
  Findings provide further evidence of poor medication adherence among youth with BP, and highlight the limits of subjective report of adherence. Providers should give careful attention to adherence when making decisions regarding treatment response and changes to medication regimen when working with youth with BP.
authors.affiliation: 1 Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center , Pittsburgh, Pennsylvania.
authors.forename: Tina R
authors.initials: TR
authors.lastname: Goldstein
authors.affiliation: 1 Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center , Pittsburgh, Pennsylvania.
authors.forename: Megan
authors.initials: M
authors.lastname: Krantz
authors.affiliation: 1 Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center , Pittsburgh, Pennsylvania.
authors.forename: John
authors.initials: J
authors.lastname: Merranko
authors.affiliation: 1 Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center , Pittsburgh, Pennsylvania.
authors.forename: Matthew
authors.initials: M
authors.lastname: Garcia
authors.affiliation: 1 Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center , Pittsburgh, Pennsylvania.
authors.forename: Loren
authors.initials: L
authors.lastname: Sobel
authors.affiliation: 2 Hospital of Fuerteventura , Canary Health Service, Canary Islands, Spain .
authors.forename: Carlos
authors.initials: C
authors.lastname: Rodriguez
authors.affiliation: 1 Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center , Pittsburgh, Pennsylvania.
authors.forename: Antoine
authors.initials: A
authors.lastname: Douaihy
authors.affiliation: 3 Nationwide Children's Hospital , Columbus, Ohio.
authors.forename: David
authors.initials: D
authors.lastname: Axelson
authors.affiliation: 1 Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center , Pittsburgh, Pennsylvania.
authors.forename: Boris
authors.initials: B
authors.lastname: Birmaher
mesh_terms: D000293:Adolescent; D001714:Bipolar Disorder / Q000188:drug therapy* / Q000503:physiopathology; D002648:Child; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D055118:Medication Adherence; D011619:Psychotropic Drugs / Q000008:administration & dosage* / Q000627:therapeutic use; D012720:Severity of Illness Index; D013997:Time Factors; D055815:Young Adult
chemical_list: D011619:Psychotropic Drugs
keywords: adolescent; bipolar disorder; medication adherence