Original Research

Psycho-demographic and clinical predictors of medication adherence in patients with bipolar I disorder in a university hospital in Egypt

Tarek A. Okasha, Doaa N. Radwan, Hussien Elkholy, Heba M.F.M. Hendawy, Eman M.M.E. Shourab, Ramy R.A. Teama, Ahmed S. Abdelgawad
South African Journal of Psychiatry | Vol 26 | a1437 | DOI: https://doi.org/10.4102/sajpsychiatry.v26i0.1437 | © 2020 Tarek A. Okasha, Doaa N. Radwan, Hussien Elkholy, Heba M.F.M. Hendawy, Eman M.M.E. Shourab, Ramy R.A. Teama, Ahmed S. Abdelgawad | This work is licensed under CC Attribution 4.0
Submitted: 30 July 2019 | Published: 10 February 2020

About the author(s)

Tarek A. Okasha, Department of Neurology and Psychiatry – Institute of Psychiatry, Faculty of Medicine, Ain Shams University, Cairo, Egypt
Doaa N. Radwan, Department of Neurology and Psychiatry – Institute of Psychiatry, Faculty of Medicine, Ain Shams University, Cairo, Egypt
Hussien Elkholy, Department of Neurology and Psychiatry – Institute of Psychiatry, Faculty of Medicine, Ain Shams University, Cairo, Egypt
Heba M.F.M. Hendawy, Department of Neurology and Psychiatry – Institute of Psychiatry, Faculty of Medicine, Ain Shams University, Cairo, Egypt
Eman M.M.E. Shourab, Department of Neurology and Psychiatry – Institute of Psychiatry, Faculty of Medicine, Ain Shams University, Cairo, Egypt
Ramy R.A. Teama, Department of Neurology and Psychiatry – Institute of Psychiatry, Faculty of Medicine, Ain Shams University, Cairo, Egypt
Ahmed S. Abdelgawad, Ministry of Health and Population, Cairo, Egypt


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Abstract

Background: Poor adherence to treatment is one of the main challenges to symptom control and preventing recurrence in bipolar disorder (BD). Numerous studies have established an association between patients’ poor adherence and an increased risk of recurrence, relapse of the symptoms and admission to hospital.

Aim: To study the socio-demographic and clinical factors associated with medication nonadherence in patients with BD who were admitted to the hospital.

Setting: The study was conducted at the Institute of Psychiatry, Ain Shams University.

Methods: A 1-year longitudinal prospective study of 110 patients, aged 18–60 years, with BD-I. Young Mania Rating Scale, Clinical Global Impression, Global Assessment of Functioning, Sheehan Disability Scale and Insight and Treatment Attitude Questionnaire were applied before and 6 months after discharge. Adherence was measured using the Morisky 8-Item Medication Adherence Scale. Sociodemographic data and level of functioning were studied in relation to adherence.

Results: Higher adherence was noticed in female, married and older patients and those with a higher level of education. However, low adherence was more common in male, non-married and less educated patients. Follow-up after 6 months revealed that the high adherence group scored the lowest in terms of disability. Meanwhile, the low adherence group scored the highest scores in disability.

Conclusion: Several socio-demographic and clinical variables were found to be associated with a low adherence rate to the prescribed medication in patients with BD-I. Age and impaired insight were found to be significant predictive factors for non-adherence.


Keywords

bipolar disorder; adherence; medication; insight; illness; severity

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