Medication nonadherence in bipolar disorder: a narrative review

Jawad, Ibrahim A.; Watson, Stuart; Haddad, Peter M.; Talbot, Peter S.; McAllister-Williams, R. Hamish

doi:10.1177/2045125318804364

Cited by 127 publications

(86 citation statements)

References 105 publications

(138 reference statements)

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“…In its clinical trial programme, overall adherence to G/P regimens has been reported at >95% with comparable rates among patients with psychiatric disorders, people who inject drugs and patients on stable opioid substitution therapy . Although treatment adherence was almost 90% in patients with bipolar disorder, nonadherence to medication was more common among patients with bipolar disorder in line with previous studies . However, it is conceivable that real‐world cohorts with more severe, untreated psychiatric disorders may be at‐risk for lower treatment adherence with DAAs including G/P.…”

Section: Discussionsupporting

confidence: 63%

Efficacy and safety of glecaprevir/pibrentasvir in patients with chronic HCV infection and psychiatric disorders: An integrated analysis

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Belperio

Bondin

et al. 2019

Journal of Viral Hepatitis

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Although direct-acting antivirals (DAAs) for chronic hepatitis C virus (HCV) infection are highly efficacious and safe, treatment initiation is often limited in patients with neuropsychiatric disorders due to concerns over reduced treatment adherence and drug-drug interactions. Here, we report adherence, efficacy, safety and patient-reported outcomes (PROs) from an integrated analysis of registrational studies using the pangenotypic DAA regimen of glecaprevir and pibrentasvir (G/P). Patients with chronic HCV genotypes 1-6 infection with compensated liver disease (with or without cirrhosis) receiving G/P for 8, 12 or 16 weeks were included in this analysis. Patients were classified as having a psychiatric disorder based on medical history and/or comedications. Primary analyses assessed treatment adherence, efficacy (sustained virologic response at post-treatment week 12; SVR12), safety and PROs. Among 2522 patients receiving G/P, 789 (31%) had a psychiatric disorder with the most common diagnoses being depression (64%; 506/789) and anxiety disorders (27%; 216/789).Treatment adherence was comparably high (>95%) in patients with and without psychiatric disorders. SVR12 rates were 97.3% (768/789; 95% CI = 96.2-98.5) and 97.5% (1689/1733; 95% CI = 96.7-98.2) in patients with and without psychiatric disorders, respectively. Among patients with psychiatric disorders, SVR12 rates remained >96% by individual psychiatric diagnoses and co-medication classes. Overall, most adverse S U PP O RTI N G I N FO R M ATI O N Additional supporting information may be found online in the Supporting Information section at the end of the article. How to cite this article: Back D, Belperio P, Bondin M, et al. Efficacy and safety of glecaprevir/pibrentasvir in patients with chronic HCV infection and psychiatric disorders: An integrated analysis. J Viral Hepat. 2019;26:951-960. https ://doi.

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Section: Discussionsupporting

confidence: 63%

Efficacy and safety of glecaprevir/pibrentasvir in patients with chronic HCV infection and psychiatric disorders: An integrated analysis

Back

Belperio

Bondin

et al. 2019

Journal of Viral Hepatitis

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“…Of note, female gender has been associated with suicide attempts in RC patients [52], supporting the hypothesis of a crucial role of sex hormones on the clinical course of BD [53]. Similarly, a higher presence of poor insight in RC versus NRC subjects has been reported by other authors [54], this aspect being consistent with the supposed long duration of illness and more advanced staging of this subtype of patients [55]. Finally, subjects with RC resulted to receive less frequently a current treatment with mood stabilizers and antidepressants.…”

Section: Variablessupporting

confidence: 72%

Correlates of current rapid-cycling bipolar disorder: Results from the Italian multicentric RENDiBi study

et al. 2019

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Background: we aimed to compare socio-demographic and clinical differences between patients with versus without current RC in order to detect clinical factors that may favor early diagnosis and personalized treatment. Methods: A total of 1675 patients (males: n = 714 and females: n = 961; bipolar 1: n = 1042 and bipolar 2: n = 633) from different psychiatric clinics were grouped and compared according to the current presence of RC in terms of socio-demographic and clinical variables. Chi-squared tests for qualitative variables and Student’s t tests for quantitative variables were executed for group comparison, and multivariable logistic regressions were performed, considering the current presence of RC as dependent variable, and socio-demographic/clinical factors as independent variables. Results: Female gender (male versus female: OR = 0.64, p = 0.04), unidentifiable prevalent polarity (versus depressive polarity: OR = 1.76, p = 0.02; versus manic polarity: OR: 2.86, p < 0.01) and hospitalization in the last year (no versus yes: OR = 0.63, p = 0.02) were found to be associated with RC in the final multivariable regression analysis. Conclusions: RC in BD seems to be more prevalent in female gender and associated with some unfavorable clinical features, such as an increased risk of hospitalization. These aspects should be taken into account in the management and monitoring of RC versus non-RC patients.

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“…In 77% of patients, at least one reason for stopping treatment came from the patients’ providers whereas in only 18% had the patient decided to stop treatment. The risk of stopping treatment might reflect worsening pain, conflicts with or disengagement from providers, particularly during exacerbations of mental health disorders (eg, aberrant behaviors, substance misuse, or mania), symptoms related to withdrawal, or a combination of these factors 153839. Our findings suggest that future studies should include all patients prescribed opioids, not just those on long term treatment, and look at suicide behaviors in addition to outcomes of overdose.…”

Section: Discussionmentioning

confidence: 92%

Associations between stopping prescriptions for opioids, length of opioid treatment, and overdose or suicide deaths in US veterans: observational evaluation

Oliva

Bowe

Manhapra

et al. 2020

BMJ

172

164

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Objective To examine the associations between stopping treatment with opioids, length of treatment, and death from overdose or suicide in the Veterans Health Administration. Design Observational evaluation. Setting Veterans Health Administration. Participants 1 394 102 patients in the Veterans Health Administration with an outpatient prescription for an opioid analgesic from fiscal year 2013 to the end of fiscal year 2014 (1 October 2012 to 30 September 2014). Main outcome measures A multivariable Cox non-proportional hazards regression model examined death from overdose or suicide, with the interaction of time varying opioid cessation by length of treatment (≤30, 31-90, 91-400, and >400 days) as the main covariates. Stopping treatment with opioids was measured as the time when a patient was estimated to have no prescription for opioids, up to the end of the next fiscal year (2014) or the patient’s death. Results 2887 deaths from overdose or suicide were found. The incidence of stopping opioid treatment was 57.4% (n = 799 668) overall, and based on length of opioid treatment was 32.0% (≤30 days), 8.7% (31-90 days), 22.7% (91-400 days), and 36.6% (>400 days). The interaction between stopping treatment with opioids and length of treatment was significant (P<0.001); stopping treatment was associated with an increased risk of death from overdose or suicide regardless of the length of treatment, with the risk increasing the longer patients were treated. Hazard ratios for patients who stopped opioid treatment (with reference values for all other covariates) were 1.67 (≤30 days), 2.80 (31-90 days), 3.95 (91-400 days), and 6.77 (>400 days). Descriptive life table data suggested that death rates for overdose or suicide increased immediately after starting or stopping treatment with opioids, with the incidence decreasing over about three to 12 months. Conclusions Patients were at greater risk of death from overdose or suicide after stopping opioid treatment, with an increase in the risk the longer patients had been treated before stopping. Descriptive data suggested that starting treatment with opioids was also a risk period. Strategies to mitigate the risk in these periods are not currently a focus of guidelines for long term use of opioids. The associations observed cannot be assumed to be causal; the context in which opioid prescriptions were started and stopped might contribute to risk and was not investigated. Safer prescribing of opioids should take a broader view on patient safety and mitigate the risk from the patient’s perspective. Factors to address are those that place patients at risk for overdose or suicide after beginning and stopping opioid treatment, especially in the first three months.

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Medication nonadherence in bipolar disorder: a narrative review

Cited by 127 publications

References 105 publications

Efficacy and safety of glecaprevir/pibrentasvir in patients with chronic HCV infection and psychiatric disorders: An integrated analysis

Efficacy and safety of glecaprevir/pibrentasvir in patients with chronic HCV infection and psychiatric disorders: An integrated analysis

Correlates of current rapid-cycling bipolar disorder: Results from the Italian multicentric RENDiBi study

Associations between stopping prescriptions for opioids, length of opioid treatment, and overdose or suicide deaths in US veterans: observational evaluation

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