Factors associated with treatment non-adherence among patients with bipolar disorder in Vietnam.

Abstract

Objectives: To identify factors associated with treatment non-adherence among patients with bipolar disorder in Vietnam.

Methods: Outpatients with bipolar disorder receiving treatment at the Bach Mai Hospital, Vietnam between November 2023 and August 2024 were recruited using convenience sampling. Medication adherence was measured using the eight-item Morisky Medication Adherence Scale (MMAS-8). The adherence and non-adherence groups were compared. Generalised multiple linear regression was conducted to assess the effects of relevant factors on the MMAS-8 score. Logistic regression analysis was conducted to identify factors associated with non-adherence.

Results: Of 121 patients with bipolar disorder included in the analysis, 53 (43.8%) were classified as treatment adherence and 68 (56.2%) as non-adherence. In the multivariable analysis, non-adherence status was positively associated with male sex (odds ratio [OR] = 5.837, p = 0.006), lower education level (OR = 3.587, p = 0.023), and receipt of >2 medications (OR = 6.832, p = 0.002), and negatively associated with married status (OR = 0.149, p = 0.002) and family encouragement (OR = 0.214, p = 0.024). In the non-adherence group, MMAS-8 scores were negatively correlated with male sex (β = -0.565, p = 0.001), distance to the clinic (β = -0.002, p = 0.038), and number of medications (β = -1.927, p = 0.030), and positively correlated with family companion during examinations (β = 0.598, p = 0.016), family reminders to take medication (β = 0.585, p = 0.019), and family management of medication (β = 0.636, p = 0.036).

Conclusion: Among patients with bipolar disorder, treatment non-adherence is associated with male sex and number of prescribed medications. Family support is important for treatment adherence; efforts to foster family involvement may improve treatment adherence.