期刊
JOURNAL OF CLINICAL PSYCHIATRY
卷 71, 期 3, 页码 296-303出版社
PHYSICIANS POSTGRADUATE PRESS
DOI: 10.4088/JCP.09m05514yel
关键词
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资金
- Eli Lilly
- Elan/Eisai
- AstraZeneca
- Bristol-Myers Squibb
- Pfizer
- Proteus Biomedical
- GlaxoSmithKline
- Concordant Rater Systems
- Alcoholism
- Alcohol Abuse
- Massachusetts General Psychiatry Academy (MGHPA)
- Janssen Pharmaceuticals
- Cyberonics
- MedAvante
- Transcept
- Supernus
- Shire
- Forest
- Cederroth
- Stanley Foundation
- Broad Institute
- Pam Labs
- NARSAD Young Investigator Award
- Sydney L. Baer Foundation Award
- Bowman Family Foundation Award
- NIMH, National Institutes of Health [N01MH80001]
Background: Poor medication adherence is common among bipolar patients. Method: We examined prospective data from 2 cohorts of individuals from the Systematic Treatment Enhancement Program for Bipolar Disorder (STEP-BD) study (1999-2005) with bipolar disorder. Clinical and sociodemographic features associated with missing at least 25% of doses of at least 1 medication were assessed using logistic regression, and a risk stratification model was developed and validated. Results: Of 3,640 subjects with 48,287 follow-up visits, 871 (24%) reported nonadherence on 20% or more study visits. Clinical features significantly associated (P<.05) with poor adherence included rapid cycling, suicide attempts, earlier onset of illness, and current anxiety or alcohol use disorder. Nonadherence during the first 3 months of follow-up was associated with less improvement in functioning at 12-month follow-up (P<.03). A risk stratification model using clinical predictors accurately classified 80.6% of visits in an independent validation cohort. Conclusion: Risk for poor medication adherence can be estimated and may be useful in targeting interventions. J Clin Psychiatry 2010;71(3):296-303 (C) Copyright 2010 Physicians Postgraduate Press, Inc.
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