Background  and  scope  of  Non-adherence  to  Bipolar  Disorder  Medication

Background and scope of Non-adherence to Bipolar Disorder Medication

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Bipolar disorder (BD) is an illness that causes extreme changes in the mood, energy, thoughts, and behavior. Manic depression is another term for bipolar disorder because it causes extreme alternating between poles manic (highs) and depression or the lows. Change in the mood can last for hours, day, days, weeks or even months.

It is a treatable condition with these medications:

  • Mood stabilizers
  • Antidepressants
  • Antipsychotics
  • Anti-anxiety medications
  • Antidepressant antipsychotic

Reasons and scope of Non-adherence to Bipolar Disorder Medication

Medication non-adherence is a big problem among patients to the extent of causing poor clinical outcomes. Those who discontinue taking mood stabilizers place the patient at risk of relapsing. Failing to take medicine for long-term conditions including Bipolar Disorder include:

  • Lack of awareness about the importance of completing a dose
  • Side effects caused by the medicine
  • Concurrent drug or alcohol abuse. The patient may forego drugs to drink or take a drug relationship between the patient and psychiatrist
  • Lack of access to medication due to cost or other factors

About 25-50% of patients with bipolar disorder entirely or partially fail to adhere to medication. Complete adhering includes taking medicine at the recommended dose, following a diet plan and executing lifestyle changes that healthcare provider prescribes. The highest rates of non-compliance occur in patients who are receiving treatment for bipolar and other psychiatric disorders.

Types of Non-adherence to Bipolar Disorder Medication

1. Full non-adherence: This is when a patient disregard entirely all instructions by the medicine provider

2. Selective non-adherence: Compliance with some instructions but ignoring others such as taking only one or two prescription medications

3. Intermittent adherence: Non-compliance during some periods, for example, failing to take medicine when abusing drugs or alcohol

4. Late adherence: Non-compliance in the initial stages but adherence at later stages. The patient with bipolar disorder can for instance increase adherence over time due to a specific intervention or an insight into illness

5. Abuse: Taking a higher dose than the prescription such as when a patient attempts to increase the effectiveness of medication by taking more

6. Behavioral non-adherence: the patient adheres to non-medicinal aspects of the treatment when it includes a broad array of behaviors than taking prescription medications. It will encompass other issues like attending scheduled appointments, implementing lifestyle changes and eating a particular diet. The patient will adhere to other requirements except taking medicine in the right way and dose.

Solution to Non-adherence to Bipolar Disorder Medication

Building a therapeutic alliance comprising of physicians, pharmacists, and the patients can make a significant contribution in ensuring adherence to treatment. The coalition will achieve its purpose and become a stable relationship if there is effective communication between the parties. Physicians should make all the efforts to convey the severity and chronic nature of bipolar disorder hence the need for treatment. They should also explain the importance of adhering to therapy in attaining a reduction of BP effects and preventing progress.

A patient who requires long-term treatment including those with bipolar disorder will become tired of medication and are more likely to have periods of non-adherence. Despite the habit, it is still essential for healthcare personnel, and those around them inform them that abrupt discontinuation of medication will increase manic or depressive relapse. The physicians should be patient and understand the concerns of their patients about taking medicine for a long time. Both sides always have different reasons for the reason to stop taking medication showing there is a need for more patient education and understandings between the parties.

Patients have more question and concerns about medicine when they are on a dose than at the beginning. It is important for pharmacists and physicians to create time for a discussion with the patients. It allows an insight into the way they are coping, and they can ask any questions they have.

It shows that other people who oversee the medication such as the patient’s family, caregiver or nursing home do not strictly follow up the prescription requirements.