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Promoting medication adherence among patients with bipolar disorder: a multicenter randomized controlled trial of a multifaceted intervention
Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science. Social Determinants of Health Research Center, Qazvin University of Medical Sciences, Qazvin, Iran.ORCID iD: 0000-0002-8798-5345
Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, USA.
Department of Rehabilitation Sciences, Faculty of Health & Social Sciences, The Hong Kong Polytechnic University, Hung Hom, Hong Kong.
Health Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran.
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2017 (English)In: Psychological Medicine, ISSN 0033-2917, E-ISSN 1469-8978, Vol. 47, no 14, 2528-2539 p.Article in journal (Refereed) Published
Abstract [en]

Background: The present research aimed to investigate the efficacy of a multifaceted intervention that included motivational interviewing (MI) and psychoeducation in improving medication adherence (MA) among patients with bipolar disorder (BD).

Method: A multicenter, cluster randomized, observer-blind, controlled, parallel-group trial was conducted in ten academic centers in Iran. Patients with BD were randomly assigned to the experimental group (EXP; n = 136) or the usual care group (UC; n = 134). The EXP group received five sessions of MI and psychoeducation together with their family members. The primary outcome measure was changes in scores on the Medication Adherence Rating Scale from baseline to 6 months post-intervention. Other outcome measures included serum levels of mood stabilizers, clinical symptoms, quality of life, as well as measures of intention, beliefs about medicine, perceived behavioral control, automaticity, action and coping planning, and adverse reactions.

Results: Medication adherence improved over time in both groups, but patients in the EXP group improved more (baseline score: 6.03; score at the sixth month: 9.55) than patients in the UC group (baseline score: 6.17; score at the sixth month: 6.67). In addition, patients in the EXP group showed greater improvement than patients in the UC group in almost all secondary outcomes 6 months following the intervention.

Conclusions: Multifaceted interventions that include motivational-interviewing and psychoeducation can significantly improve MA and clinical and functional outcomes in patients with BD.

Place, publisher, year, edition, pages
Cambridge University Press, 2017. Vol. 47, no 14, 2528-2539 p.
Keyword [en]
Adherence, bipolar disorder, mood stabilizer, motivational interviewing, psychoeducation
National Category
Psychiatry
Identifiers
URN: urn:nbn:se:hj:diva-35655DOI: 10.1017/S003329171700109XISI: 000410643500013PubMedID: 28446253Scopus ID: 2-s2.0-85018347428Local ID: HHJövrigtISOAI: oai:DiVA.org:hj-35655DiVA: diva2:1103916
Available from: 2017-05-31 Created: 2017-05-31 Last updated: 2017-10-03Bibliographically approved

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Publisher's full textPubMedScopusTrial Registration Number: (NCT02241863)

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