ArticleInternational journal of psychiatry in medicine2025
Clinical correlates of medication adherence in individuals with bipolar disorder and comorbid hypertension.
Article in International journal of psychiatry in medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
objectiveIndividuals with bipolar disorder (BD) have high rates of suboptimal medication adherence, medical illness, and premature mortality, largely from cardiovascular causes. This study examined the association between adherence to antihypertensive, adherence to BD medications, and clinical symptoms in patients with BD and comorbid hypertension (HTN). Participants were involved in an ongoing clinical trial.
methodInclusion criteria were a BD diagnosis, treatment with antihypertensives, adherence challenges, and poorly controlled HTN. Adherence was measured via self-report using the Tablets Routine Questionnaire and using eCAP, an electronic pill bottle that captures openings. Average systolic blood pressure (SBP) was calculated from 12 readings over one week. The Montgomery-Asberg Depression Rating Scale (MADRS) and the Brief Psychiatric Rating Scale (BPRS) assessed BD symptoms.
resultsA total of 83 participants with BD and HTN were included. Adherence to BD medications and antihypertensive medications were positively correlated. eCAP openings showed more missed doses than participants self-reported for antihypertensive adherence. BD medication adherence was positively correlated with BPRS at baseline, whereas antihypertensive adherence was negatively correlated with SBP at screening. Antihypertensive adherence improved and SBP decreased between screening and baseline.
conclusionsAdherence levels fluctuated over time and differed based on measurement method in participants with comorbid BD and HTN. Self-reported BD adherence was positively related to global psychiatric symptoms and antihypertensive adherence was related to better SBP control. Monitoring both medication and blood pressure led to a change in self-reported adherence. BD symptom severity may interfere with medication adherence in patients with BD and should be considered in treatment planning.
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