Nonadherence to Medication in Bipolar Disorder
In bipolar disorder, patients are often nonadherent to treatment. Over a 12-month period, a large database study showed that about 50% of patients with bipolar disorder were nonadherent to maintenance therapy and lithium. Nonadherence puts patients at a high risk of relapse, as the disorder has a recurrent nature, and the sudden termination of treatment may cause a rebound of depression and mania. Nonadherence in bipolar disorder can also be linked to a considerable heightened risk of relapse, recurrence, hospitalization, and attempts of suicide. Patients who are nonadherent also have a decreased chance of experiencing remission and recovery in addition to higher treatment costs overall. In a non-judgmental way, clinicians should routinely ask about nonadherence. To improve adherence, strategies that are related to prescribing include shared decision making, psychoeducation with focusing on adherence, and reminders. Strategies to improve adherence should be patient specific, with the clinician and patient working together.
Reference: Jawad I, Watson S, Haddad PM, Talbot PS, McAllister-Williams RH. Medication nonadherence in bipolar disorder: a narrative review. Ther Adv Psychopharmacol. 2018;8(12):349-363. doi:10.1177/2045125318804364