Abstract
Objectives: This analysis of screening and baseline data from an ongoing trial examined self-report versus automated adherence monitoring and assessed the relationship between bipolar disorder (BD) symptoms and adherence in 104 poorly adherent individuals. Methods: Adherence was measured with the Tablets Routine Questionnaire (TRQ) and the Medication Event Monitoring System (MEMS). Symptoms were measured with the Montgomery-Åsberg Depression Rating Scale (MADRS), the Young Mania Rating Scale (YMRS), and the Brief Psychiatric Rating Scale (BPRS). Results: The mean age of the sample was 46.3 years [standard deviation (SD) = 9.41 years], with 72% (n = 75) women and 71% (n = 74) African American subjects. Adherence improved from screening to baseline, with a mean missed drug proportion measured by TRQ of 61.43% (SD = 26.48%) versus a baseline mean of 46.61% (SD = 30.55%). The mean proportion of missed medication using MEMS at baseline was 66.43% (SD = 30.40%). The correlation between TRQ and MEMS was 0.47. The correlation between a single index drug and all BD medications was 0.95. Symptoms were generally positively correlated with TRQ (worse adherence = more severe symptoms), but in most instances was only at a trend level (p > 0.05), with the exception of the correlations between baseline TRQ and MADRS and BPRS, which were positive (r = 0.20 and r = 0.21, respectively) and significant (p ≤ 0.05). Conclusions: In patients with BD, monitoring increased adherence by 15%. MEMS identified 20% more non-adherence than self-report. Using a standard procedure to identify a single index drug for adherence monitoring may be one way to assess global adherence in patients with BD receiving polypharmacy treatment. Greater BD symptom severity may be a clinical indicator to assess for adherence problems.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 653-661 |
| Number of pages | 9 |
| Journal | Bipolar Disorders |
| Volume | 17 |
| Issue number | 6 |
| DOIs | |
| State | Published - Sep 1 2015 |
| Externally published | Yes |
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Keywords
- Adherence
- Bipolar disorder
- Compliance
- Depression
- Mania
- Mood stabilizer
ASJC Scopus subject areas
- Psychiatry and Mental health
- Biological Psychiatry
Cite this
Symptom severity, self-reported adherence, and electronic pill monitoring in poorly adherent patients with bipolar disorder. / Sajatovic, Martha; Levin, Jennifer B.; Sams, Johnny; Cassidy, Kristin A.; Akagi, Kouri; Aebi, Michelle E.; Ramirez, Luis F.; Safren, Steven; Tatsuoka, Curtis.
In: Bipolar Disorders, Vol. 17, No. 6, 01.09.2015, p. 653-661.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Symptom severity, self-reported adherence, and electronic pill monitoring in poorly adherent patients with bipolar disorder
AU - Sajatovic, Martha
AU - Levin, Jennifer B.
AU - Sams, Johnny
AU - Cassidy, Kristin A.
AU - Akagi, Kouri
AU - Aebi, Michelle E.
AU - Ramirez, Luis F.
AU - Safren, Steven
AU - Tatsuoka, Curtis
PY - 2015/9/1
Y1 - 2015/9/1
N2 - Objectives: This analysis of screening and baseline data from an ongoing trial examined self-report versus automated adherence monitoring and assessed the relationship between bipolar disorder (BD) symptoms and adherence in 104 poorly adherent individuals. Methods: Adherence was measured with the Tablets Routine Questionnaire (TRQ) and the Medication Event Monitoring System (MEMS). Symptoms were measured with the Montgomery-Åsberg Depression Rating Scale (MADRS), the Young Mania Rating Scale (YMRS), and the Brief Psychiatric Rating Scale (BPRS). Results: The mean age of the sample was 46.3 years [standard deviation (SD) = 9.41 years], with 72% (n = 75) women and 71% (n = 74) African American subjects. Adherence improved from screening to baseline, with a mean missed drug proportion measured by TRQ of 61.43% (SD = 26.48%) versus a baseline mean of 46.61% (SD = 30.55%). The mean proportion of missed medication using MEMS at baseline was 66.43% (SD = 30.40%). The correlation between TRQ and MEMS was 0.47. The correlation between a single index drug and all BD medications was 0.95. Symptoms were generally positively correlated with TRQ (worse adherence = more severe symptoms), but in most instances was only at a trend level (p > 0.05), with the exception of the correlations between baseline TRQ and MADRS and BPRS, which were positive (r = 0.20 and r = 0.21, respectively) and significant (p ≤ 0.05). Conclusions: In patients with BD, monitoring increased adherence by 15%. MEMS identified 20% more non-adherence than self-report. Using a standard procedure to identify a single index drug for adherence monitoring may be one way to assess global adherence in patients with BD receiving polypharmacy treatment. Greater BD symptom severity may be a clinical indicator to assess for adherence problems.
AB - Objectives: This analysis of screening and baseline data from an ongoing trial examined self-report versus automated adherence monitoring and assessed the relationship between bipolar disorder (BD) symptoms and adherence in 104 poorly adherent individuals. Methods: Adherence was measured with the Tablets Routine Questionnaire (TRQ) and the Medication Event Monitoring System (MEMS). Symptoms were measured with the Montgomery-Åsberg Depression Rating Scale (MADRS), the Young Mania Rating Scale (YMRS), and the Brief Psychiatric Rating Scale (BPRS). Results: The mean age of the sample was 46.3 years [standard deviation (SD) = 9.41 years], with 72% (n = 75) women and 71% (n = 74) African American subjects. Adherence improved from screening to baseline, with a mean missed drug proportion measured by TRQ of 61.43% (SD = 26.48%) versus a baseline mean of 46.61% (SD = 30.55%). The mean proportion of missed medication using MEMS at baseline was 66.43% (SD = 30.40%). The correlation between TRQ and MEMS was 0.47. The correlation between a single index drug and all BD medications was 0.95. Symptoms were generally positively correlated with TRQ (worse adherence = more severe symptoms), but in most instances was only at a trend level (p > 0.05), with the exception of the correlations between baseline TRQ and MADRS and BPRS, which were positive (r = 0.20 and r = 0.21, respectively) and significant (p ≤ 0.05). Conclusions: In patients with BD, monitoring increased adherence by 15%. MEMS identified 20% more non-adherence than self-report. Using a standard procedure to identify a single index drug for adherence monitoring may be one way to assess global adherence in patients with BD receiving polypharmacy treatment. Greater BD symptom severity may be a clinical indicator to assess for adherence problems.
KW - Adherence
KW - Bipolar disorder
KW - Compliance
KW - Depression
KW - Mania
KW - Mood stabilizer
UR - http://www.scopus.com/inward/record.url?scp=84940982825&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84940982825&partnerID=8YFLogxK
U2 - 10.1111/bdi.12326
DO - 10.1111/bdi.12326
M3 - Article
C2 - 26529124
AN - SCOPUS:84940982825
VL - 17
SP - 653
EP - 661
JO - Bipolar Disorders
JF - Bipolar Disorders
SN - 1398-5647
IS - 6
ER -