Medication non-adherence in bipolar disorder: Review of rates, demographic and clinical predictors

Table 4 Rates of medication non-adherence in bipolar disorder: studies of antipsychotics and antidepressants

Ref.	Study	Non-adherence rates
Antipsychotics
Keck et al[142], 1996b	n = 77 on antipsychotics; duration - 6 mo; clinical interview	32%
Svarstad et al[52], 2001	n = 56 on antipsychotics; duration 12 mo; retrospective claims data	23% irregular use
Patel et al[131], 2005	n = 32 adolescents on antipsychotics; duration - 12 mo; clinical interviews and medical records	Treatment time without full adherence in 44%
Sajatovic et al[143], 2006b	n = 32993 on antipsychotics; duration - 3 mo or more; retrospective claims data-MPR based	48% partially or fully non-adherent; took antipsychotics less than 50%-80% of the time
Sajatovic et al[144], 2007b	n = 73964 on antipsychotics; duration - 3 mo or more; retrospective claims data-MPR based	39% among those > 60 yr and 50% in those < 60 yr took antipsychotics less than 50%-80% of the time
Hassan and Lage[145], 2009	n = 1973 on antipsychotics; duration - 12 mo; retrospective claims based data-MPR based	56% took antipsychotics less than 50% of the time and 73% less than 75% of the time
Lage and Hassan[146], 2009	n = 7,769 on antipsychotics; duration- 12 mo; retrospective claims data-MPR based	62% took antipsychotics less than 50% of the time and 79% less than 75% of the time
Lang et al[147], 2011	n = 9410 on antipsychotics; duration - 12 mo; retrospective claims data-MPR based	60% took antipsychotics less than 80% of the time
Rascati et al[148], 2011	n = 2446 on SGAs; duration - 18 mo; retrospective claims data-MPR based	42% took antipsychotics less than 80% of the time
Berger et al[34], 2012	n = 84 on SGAs: Duration-6 mo; retrospective claims data-MPR and CMG based	85% took antipsychotics less than 80% of times (50% according to CMGs)
Stephenson et al[149], 2012	n = 162 patients with BD on SGAs and 153 physicians; duration - 12 mo; retrospective claims data and physician survey	57% with low-moderate adherence; physicians overestimated adherence in 67% patients
Montes et al[150], 2013	n = 303; cross-sectional study; self-reports- DAI-10 and MMAS, CRS	69%
Kutzelnigg et al[151], 2014	Olanzapine alone or in combination with mood stabilizers; n = 891 at entry; 657 at 2 yr; clinical interview	33% at baseline; 20% at 2 yr
Arvilommi et al[101], 2014	n = 168 on SGAs; duration 18 mo; clinical interview	46% fully or partially non-adherent
Sajatovic et al[152], 2016	n = 1114 on lurasidone; duration- 27 mo; retrospective claims data-MPR based	67%took lurasidone less than 80% of the time
Antidepressants
Svarstad et al[52], 2001	n = 22 on antidepressants; duration 12 mo; retrospective claims data	27% irregular use
Bauer et al[153], 2013b	n = 144 on antidepressants; duration - daily for 100 d; self-report	19% (missing/changing doses) to 41% (drug holidays)

ANT: Attitudes towards neuroleptic treatment; BD: Bipolar disorder; CMG: Cumulative medication gaps; CRS: Compliance Rating Scale; DAI-10: Drug Attitude Inventory-10 item version; MARS: Medication Adherence Report Scale (MARS-5-five item version); MMAS: Morisky Medication Adherence Scale (MMAS-8-8 item version); MPR: Medication possession ration; RBC: Red blood cells; RCBD: Rapid cycling bipolar disorder; RSM: Reasons for Stopping Medication’ questionnaire; ROMI: Rating of Medication Influences Scale; SGA: Second generation antipsychotics; SMAQ: Simplified Medication Adherence Questionnaire; SUD: substance use disorders; SRTAB: Self-reported Treatment Adherence Behaviours; TOS: Treatment Observation Form; TRQ: Tablet Routines Questionnaire.