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首页> 外文期刊>The journal of clinical psychiatry >Clinical Features Associated With Poor Pharmacologic Adherence in Bipolar Disorder: Results From the STEP-BD Study
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Clinical Features Associated With Poor Pharmacologic Adherence in Bipolar Disorder: Results From the STEP-BD Study

机译：与双相情感障碍药理学依从性差相关的临床特征：STEP-BD研究的结果

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Background: Poor medication adherence is common among bipolar patients.Method: We examined prospective data from 2 cohorts of individuals from the Systematic Treatment Enhancement Program for Bipolar Disorder (STEP-BD) study (1999-2005) with bipolar disorder. Clinical and sociodemographic features associated with missing at least 25% of doses of at least 1 medication were assessed using logistic regression, and a risk stratification model was developed and validated.Results: Of 3,640 subjects with 48,287 follow-up visits, 871 (24%) reported nonadherence on 20% or more study visits. Clinical features significantly associated (P< .05) with poor adherence included rapid cycling, suicide attempts, earlier onset of illness, and current anxiety or alcohol use disorder. Nonadherence during the first 3 months of follow-up was associated with less improvement in functioning at 12-month follow-up (P< .03). A risk stratification model usingi clinical predictors accurately classified 80.6% of visits in an independent validation cohort.Conclusion: Risk for poor medication adherence can be estimated and may be useful in targeting interventions.
机译：背景：双相情感障碍患者普遍缺乏药物依从性。方法：我们检查了来自双相情感障碍的系统性双相情感障碍治疗增强计划（STEP-BD）研究（1999-2005）的2个队列的前瞻性数据。使用Logistic回归评估了与至少25％的至少一种药物的失踪相关的临床和社会人口统计学特征，并建立并验证了风险分层模型。结果：3640名受试者进行了48287次随访，其中871名（24％ ）报告在20％或更多的研究访问中未坚持。与依从性差密切相关的临床特征（P <0.05）包括快速骑自行车，自杀未遂，疾病较早发作以及当前的焦虑或饮酒障碍。随访的前3个月不依从与12个月的随访中功能改善较少相关（P <.03）。在独立的验证队列中，使用临床预测指标的风险分层模型可以准确地将80.6％的就诊分类。结论：药物依从性差的风险可以估算，可能有助于针对性干预措施。

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