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David Baxter

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Patient beliefs about bipolar disorder affect medication adherence
By Andrew Czyzewski
01 October 2007
Bipolar Disorders 2007; 9: 656-664

Bipolar patients are less likely to take their medication if they do not accept their diagnosis, suggest the findings of a qualitative study.

Jane Clatworthy (University of London, UK), and colleagues found that patients' perceptions on various aspects of their disease affect their adherence to medication.

The study involved 16 patients diagnosed with bipolar disorder who were prescribed prophylactic mood stabilizers at outpatient clinics.

The researchers questioned the participants about their perception of illness, beliefs about medication, and adherence to medication.

Although all participants reported symptoms of bipolar disorder, some questioned their diagnosis or denied that it was a chronic illness that needed long-term medication.

The perception of bipolar disorder as a cyclical condition also affected medication adherence. Patients' perceived need for medication differed according to what stage of the cycle they were in, with some patients reluctant to take medication between episodes or at times of protracted depression.

Patients who believed their medication helped control their bipolar disorder were more likely to take it. Participants who had little faith in their medication, or who thought they could control their condition in other ways, were less likely to take medication.

Several participants reported lowering the dose of medication or not taking medication due to physical side effects. More often, however, participants reported concern about how the medications made them feel. In particular, participants were less likely to take their medication if they reported "not feeling themselves" or being limited in terms of productivity and creativity while on it.

Writing in the journal Bipolar Disorders, Clatworthy et al suggest that interventions to improve medication adherence will be more effective if they are specific to the needs of individuals.

They add: "This study provides preliminary evidence for the importance of eliciting and addressing patients' perceptions of bipolar disorder and its treatment to facilitate adherence to medication and optimum management."

Abstract
 

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