Patient and medication

NHS FT collaborates in bipolar study to understand medication hesitancy

The Norfolk and Suffolk NHS FT (NSFT), and the University of East Anglia (UEA), have conducted a study into why people diagnosed with bipolar, may not take their medication.

They found some of the reasons were because of side effects, fear of addiction, and a preference for alternative treatments. The new study (published today) revealed six key factors that stop people taking their medication as prescribed. These included difficulties in remembering to take medication, and a lack of support from family, friends and healthcare professionals.

A patient’s own beliefs and knowledge about bipolar disorder and its treatment, were also found to affect whether or not they took their medication. The study comes from a team of pharmacists, psychiatrists, and experts in behavioural science from NSFT, UEA, Devon Partnership Trust, and the University of Lyon.

The research team carried out a systematic review and included 57 studies, mostly surveys and interviews, involving 32,894 patients and healthcare professionals. The majority (79%) of the studies were conducted in the USA and Europe.

Asta Ratna Prajapati, Consultant Pharmacist at NSFT, and the post-graduate researcher at UEA’s School of Pharmacy, who led the research, said: “Bipolar disorder is a mental health condition that causes extreme mood swings that include emotional highs, known as mania or hypomania, and depressive lows.

“Around half of people with bipolar disorder don’t take their medication which can lead to a relapse of symptoms. And this can have a knock-on impact with problems at work, strained relationships with family and friends, hospitalisation, and an increased risk of suicide. We wanted to better understand what stops people from taking their medication.

“We recommend that the prescribers talk to patients about their thoughts and experiences of the medications they take, paying particular attention to these issues which may stop patients taking their meds.”

The study was funded by Health Education England, and the National Institute for Health Research Clinical Doctoral Research Fellowship. The research team are now developing a tool to identify people who struggle to take their medication and their individual reasons. They hope it will help prescribers and patients work together and offer bespoke support to make medication taking easier.

‘Mapping modifiable determinants of medication adherence in bipolar disorder (BD) to the theoretical domains framework (TDF): a systematic review, is published in the Psychological Medicine Journal.

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NHE Sept/Oct 21

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The integration of new technology, such as using virtual outpatient appointments instead of face-to-face reviews of patients in the hospital. Adapting the ways in which our NHS workers serve people has been critical in continuing to provide high-quality treatment, a positive patient experience and preventing Covid-19 transmission during the pandemic. Our healthcare sector has the potential to transform the way we continue to provide essential services while also improving patient care. But how easy is the integration of these innovations into routine NHS practice?

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