A qualitative investigation of the modifiable determinants of medication adherence in bipolar disorder (BD): Views of patients and their family and friends

Prajapati, Asta Ratna, Scott, Sion, Dima, Alexandra L., Clark, Allan, Taylor, Jo, Wilson, Jonathan and Bhattacharya, Debi (2025) A qualitative investigation of the modifiable determinants of medication adherence in bipolar disorder (BD): Views of patients and their family and friends. Journal of Affective Disorders, 382. pp. 462-470. ISSN 0165-0327

Preview

PDF (1-s2.0-S0165032725007244-main) - Published Version Available under License Creative Commons Attribution. Download (611kB) | Preview

Abstract

Background Medication nonadherence in bipolar disorder (BD) can lead to adverse outcomes including relapse, hospitalisation and suicidility. Adherence research traditionally excludes mental health populations and their family and friends, contributing to inequity between physical and mental health. We used behavioural science to characterise modifiable adherence determinants in BD from the perspectives of patients and their family and friends. Method Between April-June 2020, we conducted two focus groups and 26 interviews with adults with BD and their family and friends. We explored modifiable adherence determinants which were mapped to the Theoretical Domains Framework (TDF), followed by a thematic analysis and prioritisation of determinants. Results Sixty-three (including 13 new) adherence determinants, mapped to nine TDF domains, were prioritised. Four themes of adherence determinants emerged: the medication itself; practicalities; how patients perceive themselves, their illness, and treatments; and collaboration between patients, their family and friends, and healthcare professionals. Nine prioritised TDF domains were: ‘Environmental context and resources’, ‘Intentions’, ‘Emotion’, ‘Social Influences’, ‘Goals’, ‘Memory, attention and decision processes’, ‘Beliefs about consequences’, ‘Knowledge’ and ‘Social/professional role and identity’. Respective examples include side effects, treatment preferences, fear of not being ‘myself’, relationships with healthcare team, medication affecting life goals, forgetfulness, beliefs about negative consequences, not knowing the risk of stopping medication, and involvement in treatment decisions. Conclusion Targeting antecedents of forgetfulness as well as newly identified determinants linked to ‘Emotion’ and ‘Intentions’, may improve adherence. Mapping adherence determinants to TDF domains provides a framework for designing personalised adherence interventions by selecting appropriate behaviour change techniques.

Item Type:	Article
Uncontrolled Keywords:	sdg 3 - good health and well-being ,/dk/atira/pure/sustainabledevelopmentgoals/good_health_and_well_being
Faculty \ School:	Faculty of Science > School of Pharmacy (former - to 2024) Faculty of Science Faculty of Medicine and Health Sciences > Norwich Medical School Faculty of Social Sciences > Norwich Business School Faculty of Science > School of Chemistry, Pharmacy and Pharmacology
UEA Research Groups:	Faculty of Medicine and Health Sciences > Research Centres > Population Health Faculty of Medicine and Health Sciences > Research Groups > Epidemiology and Public Health Faculty of Medicine and Health Sciences > Research Groups > Health Services and Primary Care Faculty of Medicine and Health Sciences > Research Groups > Norwich Clinical Trials Unit Faculty of Science > Research Groups > Statistics Faculty of Social Sciences > Research Groups > Marketing Faculty of Science > Research Groups > Patient Care
Depositing User:	LivePure Connector
Date Deposited:	29 Apr 2025 15:33
Last Modified:	05 May 2025 00:10
URI:	https://ueaeprints.uea.ac.uk/id/eprint/99143
DOI:	10.1016/j.jad.2025.04.149

Downloads

Actions (login required)

View Item