Association between Adherence with an Atypical Antipsychotic and with Other Psychiatric Drugs in Patients with Bipolar Disorder

摘要

Background Using U.S. pharmacy and medical claims, medicationadherence patterns of patients with serious mental illness suggest thatadherence to atypical antipsychotics may be related to adherence to otherprescription drugs. This study investigated whether adherence to an atypicalantipsychotic was related to adherence to other prescribed psychiatric drugsusing self-reported data from patients with bipolar disorder.Methods Daily self-reported medication data were available from 123patients with a diagnosis of bipolar disorder receiving treatment as usualwho took at least 1 atypical antipsychotic over a 12-week period. Patientstook a mean of 4.0±1.7 psychiatric drugs including theantipsychotic. The adherence rate for the atypical antipsychotic wascompared to that for other psychiatric drugs to determine if the adherencerate for the atypical antipsychotic differed from that of the otherpsychiatric drug by at least ±10%.Results Of the 123 patients, 58 (47.2%) had an adherence ratefor the atypical antipsychotic that differed from the adherence rate for atleast 1 other psychiatric drug by at least±10%, and 65(52.8%) patients had no difference in adherence rates. The patientswith a difference took a larger total number of psychiatric drugs(p<0.001), had a larger daily pill burden (p=0.020) and alower adherence rate with the atypical antipsychotic (p=0.007), andwere more likely to take an antianxiety drug (p<0.001).Conclusion Adherence with an atypical antipsychotic was not useful forestimating adherence to other psychiatric drugs in about half of thepatients with bipolar disorder.