A qualitative investigation of the modifiable determinants of medication adherence in bipolar disorder (BD): Views of patients and their family and friends

IF 4.9 2区医学 Q1 CLINICAL NEUROLOGY

Journal of affective disorders Pub Date : 2025-04-24 DOI:10.1016/j.jad.2025.04.149

Asta Ratna Prajapati , Sion Scott , Alexandra L. Dima , Allan Clark , Jo Taylor , Jonathan Wilson , Debi Bhattacharya

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引用次数: 0

Abstract

Background

Medication nonadherence in bipolar disorder (BD) can lead to adverse outcomes including relapse, hospitalisation and suicidility. Adherence research traditionally excludes mental health populations and their family and friends, contributing to inequity between physical and mental health. We used behavioural science to characterise modifiable adherence determinants in BD from the perspectives of patients and their family and friends.

Method

Between April-June 2020, we conducted two focus groups and 26 interviews with adults with BD and their family and friends. We explored modifiable adherence determinants which were mapped to the Theoretical Domains Framework (TDF), followed by a thematic analysis and prioritisation of determinants.

Results

Sixty-three (including 13 new) adherence determinants, mapped to nine TDF domains, were prioritised. Four themes of adherence determinants emerged: the medication itself; practicalities; how patients perceive themselves, their illness, and treatments; and collaboration between patients, their family and friends, and healthcare professionals. Nine prioritised TDF domains were: ‘Environmental context and resources’, ‘Intentions’, ‘Emotion’, ‘Social Influences’, ‘Goals’, ‘Memory, attention and decision processes’, ‘Beliefs about consequences’, ‘Knowledge’ and ‘Social/professional role and identity’. Respective examples include side effects, treatment preferences, fear of not being ‘myself’, relationships with healthcare team, medication affecting life goals, forgetfulness, beliefs about negative consequences, not knowing the risk of stopping medication, and involvement in treatment decisions.

Conclusion

Targeting antecedents of forgetfulness as well as newly identified determinants linked to ‘Emotion’ and ‘Intentions’, may improve adherence. Mapping adherence determinants to TDF domains provides a framework for designing personalised adherence interventions by selecting appropriate behaviour change techniques.

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来源期刊

Journal of affective disorders 医学-精神病学

CiteScore

10.90

自引率

6.10%

发文量

1319

审稿时长

9.3 weeks

期刊介绍： The Journal of Affective Disorders publishes papers concerned with affective disorders in the widest sense: depression, mania, mood spectrum, emotions and personality, anxiety and stress. It is interdisciplinary and aims to bring together different approaches for a diverse readership. Top quality papers will be accepted dealing with any aspect of affective disorders, including neuroimaging, cognitive neurosciences, genetics, molecular biology, experimental and clinical neurosciences, pharmacology, neuroimmunoendocrinology, intervention and treatment trials.