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Sajatovic M, Tatsuoka C, Dines P, et al. Patient choice as a driver of medication-switching in non-adherent individuals with bipolar disorder. Patient Prefer Adherence. 2014;8:487-91doi: 10.2147/PPA.S56790.
Sajatovic, M., Tatsuoka, C., Dines, P., Bialko, C. S., Athey, M., Williams, T., & Cassidy, K. A. (2014). Patient choice as a driver of medication-switching in non-adherent individuals with bipolar disorder. Patient preference and adherence, 8487-91. https://doi.org/10.2147/PPA.S56790
Sajatovic, Martha, et al. "Patient choice as a driver of medication-switching in non-adherent individuals with bipolar disorder." Patient preference and adherence vol. 8 (2014): 487-91. doi: https://doi.org/10.2147/PPA.S56790
Sajatovic M, Tatsuoka C, Dines P, Bialko CS, Athey M, Williams T, Cassidy KA. Patient choice as a driver of medication-switching in non-adherent individuals with bipolar disorder. Patient Prefer Adherence. 2014 Apr 17;8:487-91. doi: 10.2147/PPA.S56790. eCollection 2014. PMID: 24790416; PMCID: PMC4000249.
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Patient Prefer Adherence. 2014 Apr 17;8:487-91. doi: 10.2147/PPA.S56790. eCollection 2014.

Patient choice as a driver of medication-switching in non-adherent individuals with bipolar disorder.

Patient preference and adherence

Martha Sajatovic, Curtis Tatsuoka, Philipp Dines, Christopher S Bialko, Melanie Athey, Tiffany Williams, Kristin A Cassidy

Affiliations

  1. Department of Psychiatry, Case Western Reserve University School of Medicine, University Hospitals Case Medical Center, Cleveland, OH, USA ; Department of Neurology, Case Western Reserve University School of Medicine, University Hospitals Case Medical Center, Cleveland, OH, USA.
  2. Department of Neurology, Case Western Reserve University School of Medicine, University Hospitals Case Medical Center, Cleveland, OH, USA.
  3. Department of Psychiatry, Case Western Reserve University School of Medicine, University Hospitals Case Medical Center, Cleveland, OH, USA.

PMID: 24790416 PMCID: PMC4000249 DOI: 10.2147/PPA.S56790

Abstract

OBJECTIVE: Psychotropic-related weight gain is a common concern among patients with bipolar disorder (BD). This concern affects satisfaction with treatment and may lead to non-adherence and relapse. This was a 12-week, uncontrolled prospective trial of patient-choice-facilitated ziprasidone switching among non-adherent BD patients with weight concerns. This study was conducted from January 2011 to July 2012.

METHOD: Patients were asked to identify the "offending" BD medication which they believed was causing weight problems, and this agent was replaced with ziprasidone. The primary outcome was change in adherence as measured with the Tablets Routine Questionnaire (TRQ). Secondary outcomes included medication attitudes, BD symptoms, global psychopathology, social functioning, and quality of life.

RESULTS: The most common agents causing weight concerns were quetiapine (N=7, 23%), aripiprazole (N=4, 13%), olanzapine, lithium, and divalproex (all N=3, 10%). Adherence improved from a baseline of missing 48.6% of prescribed BD medication in the past week (44.9% in the past month) to missing 25.3% (P=0.002) of prescribed BD medication in the past week (P<0.001, in the past month) at endpoint. Medication attitudes, symptoms, functioning, and quality of life improved but there were no differences in body weight.

CONCLUSION: While findings must be tempered by methodological limitations such as small sample and uncontrolled design, patient-facilitated medication-switching appeared to improve adherence and BD outcomes in these non-adherent individuals. Additional studies involving patient-facilitated medication-switching and shared decision-making in BD are needed.

Keywords: adherence; antipsychotic; bipolar disorder; shared decision-making; weight gain; ziprasidone

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