Self-reported medication adherence and its correlates in a lithium-maintained cohort with bipolar disorder at a tertiary care centre in India

Singh, Swarndeep; Kumar, Saurabh; Mahal, Pankaj; Vishwakarma, Anuranjan; Pattanayak, Raman Deep

doi:10.1016/j.ajp.2019.09.015

Cited by 7 publications

(11 citation statements)

References 54 publications

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“…However, the findings on the effects of sex on adherence have been inconsistent across studies. 17 , 27 , 32 , 33 , 37 We believe several factors may explain this finding. Women with BD are more likely to experience mixed and depressive episodes than men, 38 , 39 which implies a poor response to lithium.…”

Section: Discussionmentioning

confidence: 76%

“…More than half (52%) of the study participants were not adherent to lithium, consistent with the results from two Asian studies. 17 , 27 Non-adherence to lithium has been reported as up to 54% of patients in a Swedish study. 28 Although higher lithium adherence was reported in two Chinese studies, 19 , 20 these results were limited by subjective assessments.…”

Section: Discussionmentioning

confidence: 99%

“…Findings regarding the effects of knowledge or attitudes on lithium adherence have been inconsistent. 12 , 16 , 17 , 19 Although assessment tools represented by the LKT and LAQ have been employed in lithium adherence studies, the associations between scores and adherence do not necessarily reflect patients’ real concerns about lithium-taking behaviors. Thus, psychiatrists can optimize strategies for prescribing lithium by understanding the concrete factors associated with low adherence.…”

Section: Discussionmentioning

confidence: 99%

“… 8 Studies conducted in Asia suggested a positive association between attitudes and lithium adherence. 17 , 18 However, the underlying elements affecting lithium-taking behaviors remain unclear in China since no consistent findings from two earlier studies with small numbers of patients were found. Lee et al emphasized that therapeutic alliance was more important than better knowledge in promoting lithium adherence, 19 while Wong et al suggested that insight played a critical role.…”

Section: Introductionmentioning

confidence: 98%

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Self-Reported Low Lithium Adherence Among Chinese Patients with Bipolar Disorder in Shenzhen: A Cross-Sectional Study

Chen¹,

Zhang²,

Hou³

et al. 2022

PPA

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Background Lithium has been widely used to treat bipolar disorder (BD), although its adherence is rarely reported in China. This study aimed to explore the rate of lithium adherence and its associated factors in patients with BD, which has rarely been reported in China. Methods We conducted a cross-sectional study among patients in Shenzhen Mental Health Center (Shenzhen Kangning Hospital), who were aged 12 years or above, were diagnosed with BD based on the International Classification of Diseases, tenth edition (ICD-10), and had been on lithium for at least 1 month. We collected information on sociodemographic and clinical characteristics and on knowledge about and attitudes toward lithium. We also investigated patients’ concerns while taking lithium and where they can and wish to obtain information on lithium. Results Of the 244 enrolled patients and 221 patients aged 18 years or older, 52% and 50% disclosed low adherence to lithium, respectively. Factors associated with poor lithium adherence were a younger age (odds ratio (OR): 0.962, 95% confidence interval (CI): 0.933–0.992), female sex (OR: 2.171, 95% CI: 1.146–4.112), and no hospitalization history (OR: 0.389, 95% CI: 0.217–0.689) for the full sample, and more years of education (OR: 4.086, 95% CI: 1.397–11.946) and fewer hospitalizations (OR: 0.615, 95% CI: 0.467–0.809) for patients aged 18 years or older. Less knowledge of periodic tests conducted during lithium treatment played a critical role in low lithium adherence (regression analysis of the full sample: OR: 0.642, 95% CI: 0.532–0.775, regression analysis of subgroups: OR: 0.609, 95% CI: 0.500–0.742). The treatment duration was a major concern among patients on lithium, and patients preferred obtaining lithium-associated information through health services and WeChat. Conclusion The rate of lithium adherence was low in this study. Psychoeducation to increase lithium compliance should mainly focus on patients who are young and provide thorough background information on lithium. Health services should actively provide lithium-associated information. A greater need for medication information based on WeChat was observed, implying its potential role in adherence-related psychoeducation.

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Section: Discussionmentioning

confidence: 76%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 98%

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Self-Reported Low Lithium Adherence Among Chinese Patients with Bipolar Disorder in Shenzhen: A Cross-Sectional Study

Chen¹,

Zhang²,

Hou³

et al. 2022

PPA

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“…[ 25 ] This is also supported by a study from Delhi, which suggests that the presence of family members during psychiatric consultations and views towards lithium were discovered to be important determinants of adherence. [ 26 ]…”

Section: Discussionmentioning

confidence: 99%

Awareness and attitude about mental illness in the rural population of India: A mixed method study

Kulkarni,

Joshi,

Sathe

et al. 2023

Indian Journal of Psychiatry

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Context: Recent systematic review and meta-analysis of public attitudes have shown that despite improvements in mental health literacy, public attitudes and desire for social distance with mental illnesses have remained stable over time. Aims: To assess the awareness and attitude of the rural community towards mental disorders using the CAMI scale. Materials and Methods: This mixed method study was conducted under the ICMR-STS grant scheme after IEC approval. It included administration of a pre-tested questionnaire adapted from CAMI scale on 196 adults aged 18-60 years from an adopted village in the field practice area of medical college along with 8 in-depth interviews of key people in the same community. Thematic analysis was done for the qualitative part whereas for the quantitative part, Pearson’s correlation coefficient, independent t-test, ANOVA and Kruskall-wallis test were used. Results: Age was positively correlated with the attitude of authoritarianism, social restrictiveness, CMHI and showed a negative correlation with attitude of benevolence. Females showed higher scores for authoritarianism and social restrictiveness. There was a statistically significant difference between APL and BPL groups for authoritarianism attitude towards the mentally ill (P value = 0.02) and CMHI (P value = 0.033). It was observed that with increase in the education levels there was a rise in the mean score of the values for the attitude of benevolence but the difference wasn’t statistically significant (P > 0.05). Thematic analysis of the key informant interviews suggested various perceptions of the community regarding mental illness, available options for management, current practices of the community and what can be done further to improve facilities for mental health. Conclusions: People in the community have a varied perspective to mental illnesses which has changed for the better over time but community still approaches quacks first which warrants the need for more awareness. For this, feasibility and effectiveness of increasing involvement of females from the community in health-related decisions can be explored further. We recommend further awareness generation in the younger generation with community-based research on perceptions of the community about mental health. This will provide more practical and feasible solutions to complement the national mental health program.

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Trajectories of medication adherence in patients with Bipolar Disorder along 2 years-follow-up

Consoloni

M’Baïlara

Perchec

et al. 2021

Journal of Affective Disorders

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Self-reported medication adherence and its correlates in a lithium-maintained cohort with bipolar disorder at a tertiary care centre in India

Cited by 7 publications

References 54 publications

Self-Reported Low Lithium Adherence Among Chinese Patients with Bipolar Disorder in Shenzhen: A Cross-Sectional Study

Self-Reported Low Lithium Adherence Among Chinese Patients with Bipolar Disorder in Shenzhen: A Cross-Sectional Study

Awareness and attitude about mental illness in the rural population of India: A mixed method study

Trajectories of medication adherence in patients with Bipolar Disorder along 2 years-follow-up

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