Nearly half of people with bipolar do not take their medication increasing risk of suicide

Almost half of people with bipolar disorder do not take their medication which increases their risk of relapsing, hospitalisation and suicide.

A study by Norfolk and Suffolk NHS Foundation Trust (NSFT) and the University of East Anglia (UEA) found this is due to side effects, fear of addiction and a preference for alternative treatment.

Other reasons were difficulties in remembering to take medication and a lack of support from family, friends and healthcare professionals.

Asta Ratna Prajapati, consultant pharmacist at NSFT and a post-graduate researcher at UEA’s School of Pharmacy, led the research. The study was funded by a Health Education England (HEE) / National Institute for Health Research Clinical Doctoral Research Fellowship.

He 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.”

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 per cent) of the studies were conducted in the USA and Europe.

“We found six key factors that affect whether people take their medication. The main reason being what the medication is like, whether there are side effects, and whether it works,” said Mr Prajapati.

“Secondly, we found that a patient’s beliefs and knowledge about bipolar disorder and its treatment could stop them taking medication.

“We also found that how patients felt taking their medication had an impact – for example a fear of addiction or worry about negative side effects.

“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 research team is developing a tool to identify people who struggle to take their medication and their reasons. They hope it will help prescribers and patients work together and offer tailored support to make medication taking easier.

The study ‘Mapping modifiable determinants of medication adherence in bipolar disorder (BD) to the theoretical domains framework (TDF)' was published in the Psychological Medicine Journal on 19 May 2021.