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Category: Volume 07 Issue 06 June 2019
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Title: Prevalence of Non-Adherence to Treatment among Patients of Bipolar Affective Disorder

Authors: Rameshwar S Manhas, Gaurav S Manhas, Angli Manhas, Rishabh Sharma, Jagdish R Thappa, Rukhsana Akhter

 DOI: https://dx.doi.org/10.18535/jmscr/v7i6.107

Abstract

Background: Management of bipolar disorder include acute management aimed at reducing acute symptoms and maintenance management aimed to reduce the possibility of relapse and to reduce the risk of suicide by addressing incomplete remission, quality of life and functional impairment. Adherence to medication is a problem in bipolar disorder which contributes substantially to efficacy effectiveness gap and the burden of morbidity and mortality of the illness.

Aims: To find prevalence of non adherence to treatment in patients of bipolar affective disorder.

Materials & Methods: This is a cross-sectional study which was conducted on patients with bipolar affective disorder attending the outpatient department (OPD) of Government Psychiatric Diseases Hospital, Jammu. After meeting inclusion and exclusion criteria, total of 109 patients were selected for the study. Various parameters like age, sex, education, marital status etc were collected. A patient is said to be non adherent to treatment if skips more 3 doses in month and adherent if skips less 3 doses in a month.

Results: Prevalence of non adherence to treatment among the bipolar patients was 59.6%. About 76.5% patients below 20 years of age, 61.8% males, 65.8% from rural areas, 75% uneducated, 76.6% unemployed and 64.9% married patients were non adherent to treatment. Patients who had parents as their caretakers had lower rates whereas those belonging to lower socioeconomic class had higher rates of non adherence.

Conclusion: There is high prevalence of non adherence among patients suffering from bipolar affective disorder which may affect the treatment outcome and management of these patients and thus it is suggested that better health education to these patients and their attendants should be given in order to maintain compliance to treatment and prevention of relapses.

Keywords: BPAD, Non Adherence, Prevalence.

References

  1. Kessler RC et al. Lifetime and 12 month prevalence of DSM-II-R psychiatric disorders in the United Harris States. Results from the national comorbidity study. Arch Gen Psychiatry 1994; 51: 8–19.
  2. EC and Barraclough B. Suicide as an outcome for mental disorders: a meta-analysis. Br J Psychiatry 1997; 170: 205–228.
  3. Sachs GS and Rush AJ. Response, remission and recovery in bipolar disorders: what are the realistic treatment goals? J Clin Psychiatry 2003; 64: 18–22.
  4. Guscott R and Taylor L. Lithium prophylaxis in recurrent affective illness: efficacy effectiveness and efficiency. Br J Psychiatry 1994; 164: 741–746.
  5. Sajatovic M et al. Enhancement of treatment adherence among patients with bipolar disorder. Psychiatr Serv 2004; 55: 264–269.
  6. Lingam R and Scott J. Treatment non-adherence in affective disorders. Acta Psychiatra Scandinavia 2002; 105: 164–172.
  7. Scott J and Pope M. Non adherence with mood stabilizers: prevalence and predictors. J Clin Psychiatry 2002; 63:384–390.
  8. Sharma S et al. Prevalence and factors associated with medication compliance in Indian patients suffering from mental disorders. Trop Doct 2012:42: 28.
  9. Fenton WS, Blyer CR and Heinssen RK. Determinants of medication compliance in schizophrenia: empirical and clinical findings. Schizophr Bull 1997;23:637–651.
  10. Scott J. Predicting medication non-adherence in severe affective disorders. Acta Neurolopsychiatr 2000; 12: 128-130.
  11. Bech P et al. Lithium maintenance treatment of manic-melancholic patients: its role in the daily routine. Acta Psychiatr Scand 1976; 53: 70 -81.
  12. Connelly CE et al. Adherence to treatment regimen in a lithium carbonate clinic. Arch Gen Psychiatry 1982;39:585-588.
  13. Cochran SD. Compliance with lithium regimens in the out-patient treatment of bipolar affective disorders. J Compliance Health Care 1986;1:151-169.
  14. Berk M et al. A collaborative approach to the treatment alliance in bipolar disorder. Bipolar Disorders 2004: 6: 504–518.
  15. Keck PE et al. Compliance with maintenance treatment in bipolar disorder. Psychopharmacol Bull 1997; 33: 87–91.
  16. Goodwin F et al. Manic Depressive illness. New York: Oxford University Press, 1990.
  17. Ritchie CW et al. Predictors of adherence to atypical antipsychotics (risperidone or olanzapine) in older patients with schizophrenia: an open study of 3 1/2 years duration. Int J Geriatr Psychiatry 2010;25:411–18.
  18. Dolder CR et al. Interventions to improve antipsychotic medication adherence: review of recent literature. J Clin Psychopharmacol 2003;23:389–99.
  19. Trivedi JK. Prescription pattern of mood stabilizers for bipolar disorder at a tertiary health care centre in north India. Indian journal of psychiatry 2013;55(2): 131-134.
  20. Swartz M et al. Violence and severe mental illness: the e€ects of substance misuse and non-adherence to medication. Am J Psychiatry 1998;155:226-231.
  21. Goodwin F, Jamison JK. Manic Depressive illness. New York: Oxford University Press, 1990.
  22. Danion JM, Neunrither C, Krieger-Finance F et al. Compliance with long-term lithium treatment in major affective disorders. Pharmacopsychiatry 1987; 20: 230–231.
  23. Frank E, Prien RF, Kupfer DJ, Alberts L. Implication of non-compliance in research in affective disorders. Psychopharmacological. Bulletin 1985; 21: 37–42.
  24. Lacro JP, Dunn LB, Dolder CR, Leckband SG, Jeste DV. Prevalence of and risk factors for medication non-adherence in patients with schizophrenia: a comprehensive review of recent literature. J Clin Psychiatry 2002;63:892–909.
  25. Buchanan A. A two-year prospective study of treatment compliance in patients with schizophrenia. Psychol Med 1992;22: 787–97.
  26. Sadock BJ, Sadock VA. Mood disorders in: Kaplan & Sadock's Synopsis of Psychiatry: Behavioral Sciences/Clinical Psychiatry. 10th ed. Lippincott Williams & Wilkins; 2007;Chapter15:527-578.
  27. Chadda RK. Caring for the family caregivers of persons with mental illness. Indian Journal of Psychiatry 2014;56(3):221-227.

Corresponding Author

Dr Gaurav S Manhas MBBS,MD

R\O : 381-A Indira Colony, Timber Road, Janipur, Jammu, J&K, India