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Administration and Policy in Mental Health and Mental Health Services Research

Published in:

01-03-2011 | Original Paper

Medication Adherence, Ethnicity, and the Influence of Multiple Psychosocial and Financial Barriers

Authors: John E. Zeber, Alexander L. Miller, Laurel A. Copeland, John F. McCarthy, Kara Zivin, Marcia Valenstein, Devra Greenwald, Amy M. Kilbourne

Published in: Administration and Policy in Mental Health and Mental Health Services Research | Issue 2/2011

Abstract

Medication adherence is critical for patients with bipolar disorder to avoid symptom exacerbation and diminished quality of life. Most analyses consider adherence barriers individually rather than conjointly, while neglecting potential ethnic differences. 435 patients in the Continuous Improvement for Veterans in Care––Mood Disorders study reported multiple financial and psychosocial factors influencing adherence. Logistic regression modeled adherence as a function of perceived barriers, including cost burden, access, binge drinking, poor therapeutic alliance, and medication beliefs. Nearly half the cohort experienced adherence difficulty, averaging 2.8 barriers, with minority veterans reporting lower adherence than white patients, particularly financial burden and treatment access. Total barriers were significantly associated with worse adherence (OR = 1.24 per barrier), notably poor medication beliefs, binge drinking, and difficulty accessing psychiatric specialists (ORs of 2.41, 1.95 and 1.73, respectively). Veterans with bipolar disorder experience numerous adherence barriers, with certain obstacles proving especially pernicious. Fortunately tailored clinical interventions can improve adherence, particularly by addressing modifiable risk factors.

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Title: Medication Adherence, Ethnicity, and the Influence of Multiple Psychosocial and Financial Barriers
Authors: John E. Zeber
Alexander L. Miller
Laurel A. Copeland
John F. McCarthy
Kara Zivin
Marcia Valenstein
Devra Greenwald
Amy M. Kilbourne
Publication date: 01-03-2011
Publisher: Springer US
Published in: Administration and Policy in Mental Health and Mental Health Services Research / Issue 2/2011
Print ISSN: 0894-587X
Electronic ISSN: 1573-3289
DOI: https://doi.org/10.1007/s10488-010-0304-1

At a glance: The STEP trials

Springer Medicine

Medication Adherence, Ethnicity, and the Influence of Multiple Psychosocial and Financial Barriers

Abstract

At a glance: The STEP trials

Springer Medicine

Abstract

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