title: Medication Adherence in Patients with Bipolar Disorder: A Comprehensive Review.
abstract: Poor medication adherence is a pervasive problem that causes disability and suffering as well as extensive financial costs among individuals with bipolar disorder (BD). Barriers to adherence are numerous and cross multiple levels, including factors related to bipolar pathology and those unique to an individual's circumstances. External factors, including treatment setting, healthcare system, and broader health policies, can also affect medication adherence in people with BD. Fortunately, advances in research have suggested avenues for improving adherence. A comprehensive review of adherence-enhancement interventions for the years 2005-2015 is included. Specific bipolar adherence-enhancement approaches that target knowledge gaps, cognitive patterns, specific barriers, and motivation may be helpful, as may approaches that capitalize on technology or novel drug-delivery systems. However, much work remains to optimally facilitate long-term medication adherence in people with BD. For adherence-enhancement approaches to be widely adapted, they need to be easily accessible, affordable, and practical.
authors.affiliation: Department of Psychiatry, Case Western Reserve University School of Medicine, University Hospitals Case Medical Center, 10524 Euclid Avenue, Cleveland, OH, 44106, USA. jennifer.levin@uhhospitals.org.|Neurological and Behavioral Outcomes Center, University Hospitals Case Medical Center, Cleveland, OH, 44106, USA. jennifer.levin@uhhospitals.org.
authors.forename: Jennifer B
authors.identifier: 0000-0002-3073-668X
authors.initials: JB
authors.lastname: Levin
authors.affiliation: Department of Psychiatry, Case Western Reserve University School of Medicine, University Hospitals Case Medical Center, 10524 Euclid Avenue, Cleveland, OH, 44106, USA.|Department of Psychology, Cleveland State University, 2300 Chester Avenue, Cleveland, OH, 44115, USA.
authors.forename: Anna
authors.initials: A
authors.lastname: Krivenko
authors.affiliation: Department of Psychiatry, Case Western Reserve University School of Medicine, University Hospitals Case Medical Center, 10524 Euclid Avenue, Cleveland, OH, 44106, USA.
authors.forename: Molly
authors.initials: M
authors.lastname: Howland
authors.affiliation: Department of Psychiatry, Case Western Reserve University School of Medicine, University Hospitals Case Medical Center, 10524 Euclid Avenue, Cleveland, OH, 44106, USA.
authors.forename: Rebecca
authors.initials: R
authors.lastname: Schlachet
authors.affiliation: Department of Psychiatry, Case Western Reserve University School of Medicine, University Hospitals Case Medical Center, 10524 Euclid Avenue, Cleveland, OH, 44106, USA.|Neurological and Behavioral Outcomes Center, University Hospitals Case Medical Center, Cleveland, OH, 44106, USA.|Department of Neurology, Case Western Reserve University School of Medicine, University Hospitals Case Medical Center, 10524 Euclid Avenue, Cleveland, OH, 44106, USA.
authors.forename: Martha
authors.initials: M
authors.lastname: Sajatovic
mesh_terms: D001714:Bipolar Disorder / Q000188:drug therapy* / Q000503:physiopathology; D016503:Drug Delivery Systems; D007722:Health Knowledge, Attitudes, Practice; D006291:Health Policy; D006801:Humans; D055118:Medication Adherence; D009042:Motivation