Medication Related Factors of Adherence and Attitude to Medication among Outpatients with Bipolar Disorder in Uyo, South-South Nigeria

A high level of medication adherence is required for effective treatment of bipolar disorder due to the chronic progressive nature of the illness requiring maintenance treatment.

Aims: This study was conducted to determine the prevalence of medication non-adherence of people with bipolar affective disorder and explore the roles of attitude to medication and medication related factors in promoting treatment adherence.

Materials and Methods: This was a cross-sectional descriptive study conducted on a sample of one hundred and twenty six out-patients with bipolar affective disorder. Adherence to medication was assessed on the basis of patients’ self report. Socio-demographic parameters, attitude to medication and medication related variables were collected and compared between adherent and non-adherent participants. Logistic regression analysis model was used to determine predictors of treatment non-adherence.

Results: The mean age of participants was 34.4±9.84 and 69.0% were males. Prevalence of medication non-adherence was 56.7%. Factor that significantly associated with medication non-adherence were high cost of medication (x2=25.8, P<.001). By multiple regression analysis, factors that independently predicted non-adherence to treatment were: a lack supportive marital union (OR=7.42,P=.009), poor attitude to medication (OR=0.06 P<.001), high dosing frequency of medication (OR=0.18,P=.05) and high side effects burden of medication (OR=19.52,P=.04).

Conclusion: A high prevalence of treatment non-adherence was found in a sample of outpatients with bipolar disorder in a mental health service in Nigeria. Psycho-educational Interventions and measures that reduce treatment cost are required to improve medication adherence.