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Article Dans Une Revue Journal of Affective Disorders Année : 2021

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

Julia-Lou Consoloni
Katia M'Bailara
  • Fonction : Auteur
Cyrille Perchec
  • Fonction : Auteur
Bruno Aouizerate
  • Fonction : Auteur
Valérie Aubin
  • Fonction : Auteur
Jean-Michel Azorin
  • Fonction : Auteur
Frank Bellivier
  • Fonction : Auteur
Nadia Correard
  • Fonction : Auteur
Philippe Courtet
  • Fonction : Auteur
Caroline Dubertret
  • Fonction : Auteur
Bruno Etain
Sébastien Gard
  • Fonction : Auteur
Emmanuel Haffen
  • Fonction : Auteur
Marion Leboyer
  • Fonction : Auteur
Pierre-Michel Llorca
  • Fonction : Auteur
Emilie Olié
  • Fonction : Auteur
Mircea Polosan
  • Fonction : Auteur
Raymund Schwan
  • Fonction : Auteur
Ludovic Samalin
  • Fonction : Auteur
Raoul Belzeaux

Résumé

Background: Bipolar disorder (BD) is a chronic and severe mental illness. It requires a non-discontinued pharmacological treatment to prevent mood recurrences but nonadherence to medication is frequent. To this date, medication adherence in BD has been mostly evaluated in cross-sectional studies and often considered as a stable trait. We aimed to study medication adherence using a prospective person-oriented approach. Methods: 1627 BD patients were followed on a 2 years period and assessed every 6 months. Medication adherence was evaluated at each visit with the Medication Adherence Rating Scale (MARS). A latent class mixed model (LCMM) was used to identify trajectory classes of adherence over time. Regression analyses and linear mixed model were used to search for predictors and covariables of the trajectories. Results: Three distinct and robust trajectories of medication adherence have been identified: one that starts poorly and keeps deteriorating (4.8%), one that starts poorly but improves (9%) and one that starts well and keeps improving (86.2%). A good tolerance to psychotropic medications, low depressive symptoms, the absence of comorbid eating disorders and anticonvulsant medication were associated to a better prognosis of adherence. Along the follow-up, the lower were the depressive symptoms, the better was the medication adherence (p <.001) Limitations: The use of a single measure of medication adherence although it is a validated instrument and a possible positive selection bias that might limit the generalization of our findings. Conclusions: This study demonstrates that medication adherence in BD patients is a heterogeneous and potentially variable phenomenon.
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Dates et versions

hal-03171247 , version 1 (01-07-2022)

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Julia-Lou Consoloni, Katia M'Bailara, Cyrille Perchec, Bruno Aouizerate, Valérie Aubin, et al.. Trajectories of medication adherence in patients with Bipolar Disorder along 2 years-follow-up. Journal of Affective Disorders, 2021, 282, pp.812-819. ⟨10.1016/j.jad.2020.12.192⟩. ⟨hal-03171247⟩
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