THURSDAY, May 20, 2021 (HealthDay News) – Clinicians may underestimate the reasons why patients with bipolar disorder (TB) do not take their medications, according to a review published online May 19 in Psychological medicine.
Asta Ratna Prajapati, University of East Anglia in Norwich, England, and colleagues conducted a systematic review of the literature to identify studies reporting modifiable determinants of drug adherence in BD.
Based on 57 studies (32,894 participants), the researchers found that the patient-reported determinants covered 11 of the 14 domains of the Theoretical Domains Framework (TDF), compared to six domains represented by the clinician / researcher. The most frequently represented TDF domains included: environmental context and resources (63 percent; eg experiencing side effects); beliefs about consequences (63 percent; eg, beliefs about the effects of drugs); knowledge (40 percent; eg, knowledge of the disorder); social influences (33 percent; eg, family support / clinicians); memory, attention and decision processes (33 percent; for example, forgetting); emotion (21 percent; eg, fear of addiction); and intentions (21 percent; for example, wanting alternative treatment). The areas only reported by patients were intentions; memory, attention and decision-making; and emotion.
“Clinicians may underestimate the full range of modifiable determinants of adherence and thus fail to provide adherence support that reflects patient needs,” the authors write.