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Predicting medication non-adherence in severe affective disorders

Published online by Cambridge University Press:  18 September 2015

J. Scott*
Affiliation:
Dept of Psychological Medicine, University of Glasgow, Glasgow, U.K.
*
Dept of Psychological Medicine, University of Glasgow, Gartnavel Royal Hospital, Glasgow G12 OXH, United Kingdom

Abstract

Objective This study explored the utility of the Health Belief Models (HBM) in explaining medication adherence in subjects with severe affective disorders.

Method Well established measuring instruments, with confirmed reliability and validity, were used to assess each component of two HBMs and adherence with mood stabilising medication in 104 subjects with bipolar (n=82), unipolar (n=18) or schizo-affective (n=4) disorders.

Results Highly adherent and partially adherent subjects differed significantly in the stability of the level and the overall serum level of drug acheived. Subject's beliefs about themselves and their illness and their control over the disorder were more important than side-effects in predicting medication adherence. There were marked differences in the primary reasons for non-adherence identified by patients and their clinicians.

Conclusion Although the study has a number of methodological limitations, the results suggest that clinical assessment of components of HBMs may improve the detection of patients at risk of non-adherence with mood stabilising medication.

Type
Articles
Copyright
Copyright © Cambridge University Press 2000

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References

1.Stephenson, BJ, Rowe, BH, Ilayncs, RB, Macharia, WM, Leon, G. Is this patient taking the treatment as prescribed? J Am Med Ass 1993;269:27792781.CrossRefGoogle ScholarPubMed
2.Dickson, W, Kendall, R. Does maintenance lithium therapy prevent recurrence of mania under ordinary clinical conditions? Psychol Med 1986:16:521530.CrossRefGoogle ScholarPubMed
3.Keck, P, McElroy, B, Strakowski, S, Stanton, S, Kizer, D, Balisteri, Tet al. Factors associated with pharmacologic non-compliance in patients with mania. J Clin Psychiatry 1996;57:292297.Google Scholar
4.Myers, E, Brainthwaite, A. Outpatient compliance with antidepressant medication. Br J Psychiatry 1992;160:8386.CrossRefGoogle ScholarPubMed
5.Becker, MH, Maimon, LA. Sociobehavioural determinants of compliance with health and medical care recommendations. Med Care 1975:13:1024.CrossRefGoogle Scholar
6.Scott, J. Psychotherapy for bipolar disorder. Br J Psychiatry 1995;167:581588.CrossRefGoogle ScholarPubMed
7.Jamison, KR, Gemer, RG, Goodwin, FK. Patient and physical attitudes towards lithium. Arch Gen Psychiatry 1979;36:866869.CrossRefGoogle Scholar
8.Horne, R, Weinman, J. Predicting treatment adherence: An overview of theoretical models. In Myers, L, Midence, K (eds). Adherence to Treatment in Medical Conditions. UK, Harwood Academic Publishers, pp 124156.Google Scholar
9.Janz, NK, Becker, MH. The health belief model: a decade later. Health Educ Quarterly 1984;11:147.CrossRefGoogle ScholarPubMed
10.Adams, J, Scott, J. Predicting medication adherence in severe mental disorders. Acta Psychiatr Scand 2000;101:16.CrossRefGoogle ScholarPubMed
11.Connelly, CE, Davenport, YB, Nurnberhcr, JI. Adherence to treatment regimen in a lithium carbonate clinic. Arch Gen Psychiatry 1982;39:585588.CrossRefGoogle Scholar
12.Weiden, P, Rapkin, B, Mott, T, Zygmunt, A, Goldman, D, Horvitz-Lennon, M, Frances, A. Rating of Medication Influences (ROMI) Scale in schizophrenia. Schizophr Bull 1994:20:297307.CrossRefGoogle ScholarPubMed
13.Chose, K. Lithium salts: therapeutic and unwanted effects. Br J Hosp Med 1977:18:578583.Google Scholar
14.Peet, M, Harvey, N. Lithium maintenance: Effects of personality and attitude on health information acquisition and compliance. Br J Psychiatry 1991:158:200204.Google Scholar
15.Scott, J. Cognitive and behavioural approaches to improving adherence with medication. Adv Psychiatr Treatment. 1999:5:338347.CrossRefGoogle Scholar