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Citation |
Levin JB, Sams J, Tatsuoka C, Cassidy KA, Sajatovic M. Ther. Adv. Psychopharmacol. 2015; 5(2): 76-87. |
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Copyright |
(Copyright © 2015, SAGE Publishing) |
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DOI |
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PMID |
unavailable |
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Abstract |
Medication nonadherence occurs in 20-60% of persons with bipolar disorder (BD) and is associated with serious negative outcomes, including relapse, hospitalization, incarceration, suicide and high healthcare costs. Various strategies have been developed to measure adherence in BD. This descriptive paper summarizes challenges and workable strategies using electronic medication monitoring in a randomized clinical trial (RCT) in patients with BD. Descriptive data from 57 nonadherent individuals with BD enrolled in a prospective RCT evaluating a novel customized adherence intervention versus control were analyzed. Analyses focused on whole group data and did not assess intervention effects. Adherence was assessed with the self-reported Tablets Routine Questionnaire and the Medication Event Monitoring System (MEMS). The majority of participants were women (74%), African American (69%), with type I BD (77%). Practical limitations of MEMS included misuse in conjunction with pill minders, polypharmacy, cost, failure to bring to research visits, losing the device, and the device impacting baseline measurement. The advantages were more precise measurement, less biased recall, and collecting data from past time periods for missed interim visits. Automated devices such as MEMS can assist investigators in evaluating adherence in patients with BD. Knowing the anticipated pitfalls allows study teams to implement preemptive procedures for successful implementation in BD adherence studies and can help pave the way for future refinements as automated adherence assessment technologies become more sophisticated and readily available. © 2015, SAGE Publications. All rights reserved. Language: en |
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Keywords |
human; female; male; bipolar disorder; randomized controlled trial; polypharmacy; African American; major clinical study; controlled study; questionnaire; treatment planning; self report; priority journal; psychotropic agent; health care cost; patient compliance; drug cost; automation; drug monitoring; Article; clinical assessment tool; medication compliance; medication adherence; electronic data interchange; medication event monitoring system |