The authors of this paper do not have any commercial associations that might pose a conflict of interest in connection with this manuscript.
Adherence to medication in bipolar disorder: a qualitative study exploring the role of patients’ beliefs about the condition and its treatment
Article first published online: 5 SEP 2007
Volume 9, Issue 6, pages 656–664, September 2007
How to Cite
Clatworthy, J., Bowskill, R., Rank, T., Parham, R. and Horne, R. (2007), Adherence to medication in bipolar disorder: a qualitative study exploring the role of patients’ beliefs about the condition and its treatment. Bipolar Disorders, 9: 656–664. doi: 10.1111/j.1399-5618.2007.00434.x
- Issue published online: 5 SEP 2007
- Article first published online: 5 SEP 2007
- Received 14 September 2005, revised and accepted for publication 28 July 2006
- illness perceptions;
- patient compliance;
- treatment perceptions
Objectives: Patients’ perceptions of illness and treatment have been found to predict adherence to medication in many chronic conditions. This has not yet been fully explored in bipolar disorder (BD). The aim was to use a qualitative methodology to explore in depth the beliefs about BD and its treatment that are associated with adherence to medication prescribed for BD.
Methods: Sixteen adults prescribed prophylactic treatment for BD completed semi-structured interviews about their perceptions of BD and its treatment and their adherence to medication. Interviews were recorded and transcribed verbatim. Two researchers identified perceptions associated with non-adherence in the transcripts.
Results: Thirteen participants (81%) reported some degree of intentional or unintentional medication non-adherence. Intentional non-adherence was associated with patients’ concerns about the prescribed medication, arising from the experience of side effects, but also from beliefs that regular use could lead to adverse effects in the future. Intentional non-adherence was also associated with doubts about the personal need for medication, which were related to perceptions of BD (e.g., not accepting diagnosis, believing the condition is not controllable, believing it is not a chronic condition).
Conclusions: This study has identified some of the salient beliefs about BD and its treatment that should be elicited and addressed in interventions to facilitate adherence to medication. Further quantitative work is justified to explore the utility of this approach in the development of interventions.