Predictors of nonadherence among individuals with bipolar disorder receiving treatment in a community mental health clinic.
Predictors of nonadherence among individuals with bipolar disorder receiving treatment in a community mental health clinic.
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DOI：
10.1016/j.comppsych.2008.06.008
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发表时间：
2009-03
影响因子：
7.3
通讯作者：
Blow, Frederic C.
中科院分区：
文献类型：
--
作者：
Sajatovic, Martha;Ignacio, Rosalinda V.;West, Jane A.;Cassidy, Kristin A.;Safavi, Roknedin;Kilbourne, Amy M.;Blow, Frederic C.
在双相情感障碍（BPD）人群中，主观疾病经历是治疗依从性的重要组成部分。这项横断面分析研究了140名接受情绪稳定药物治疗的BPD患者与依从性相关的临床和主观变量。不依从定义为片剂常规问卷（TRQ）中缺失30%或更多的药物，这是一种自我报告的药物治疗依从性指标。依从组和非依从组对疾病和治疗的态度进行了比较，包括对情绪稳定剂的态度问卷（AMSQ），洞察力和治疗态度问卷（ITAQ），药物影响的评级（ROMI）和多维健康控制量表（MHLC）。除药物滥用合并症外，依从性个体（N=113，80.7%）与非依从性个体（N=27，19.3%）在临床变量上没有差异。然而，非依从性个体对疾病的洞察力降低，对药物的态度更消极，依从性的原因更少，与依从性个体相比，非依从性的原因更多。不依从性的最强态度预测因素是常规用药困难（OR 2.2）和对药物的一般消极态度（OR 2.3）。结果解释受限于横断面设计、自我报告方法和样本量。共病药物滥用，对情绪稳定药物的消极态度，以及在日常安排的背景下难以管理服药是药物治疗依从性的主要决定因素。一个以病人为中心的，合作的护理模式，解决对药物的消极态度和难以应付的药物常规使用可能是理想的适合解决个人的依从性的挑战。
Subjective experience of illness is a critical component of treatment adherence in populations with bipolar disorder (BPD). This cross-sectional analysis examined clinical and subjective variables in relation to adherence in 140 individuals with BPD receiving treatment with mood stabilizing medication. Non-adherence was defined as missing 30% or more of medication on the Tablets Routine Questionnaire (TRQ), a self-reported measure of medication treatment adherence. Adherent and non-adherent groups were compared on measures of attitudes towards illness and treatment including the Attitudes towards Mood Stabilizers Questionnaire (AMSQ), the Insight and Treatment Attitudes Questionnaire (ITAQ), The Rating of Medication Influences (ROMI), and the Multidimensional Health Locus of Control Scale (MHLC). Except for substance abuse comorbidity, adherent individuals (N=113, 80.7%) did not differ from non-adherent individuals (N=27, 19.3%) on clinical variables. However, non-adherent individuals had reduced insight into illness, more negative attitudes towards medications, fewer reasons for adherence, and more perceived reasons for non-adherence compared to adherent individuals. The strongest attitudinal predictors for non-adherence were difficulties with medication routines (OR 2.2) and negative attitudes towards drugs in general (OR 2.3). Results interpretation is limited by cross-sectional design, self-report methodology and sample size. Comorbid substance abuse, negative attitudes towards mood stabilizing medication, and difficulty managing to take medication in the context of one's daily schedule are primary determinants of medication treatment adherence. A patient-centered, collaborative model of care that addresses negative attitudes towards medication and difficulty coping with medication routines use may be ideally suited to address individual adherence challenges.
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影响因子：
1.9
作者：
Cassidy, F;McEvoy, JP;Wilson, WH
通讯作者：
Wilson, WH
影响因子：
1.9
作者：
COCHRAN, SD;GITLIN, MJ
通讯作者：
GITLIN, MJ
影响因子：
3.8
作者：
Bauer, Mark S.;McBride, Linda;Sajatovic, Martha
通讯作者：
Sajatovic, Martha
影响因子：
6.6
作者：
Dharmendra, MS;Eagles, JM
通讯作者：
Eagles, JM
影响因子：
3.8
作者：
Clark, Robin E.;Samnaliev, Mihail;McGovern, Mark P.
通讯作者：
McGovern, Mark P.