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Using Health Belief Models to understand the efficacy-effectiveness gap for mood stabilizer treatments
1Institute of Psychiatry, London, UK. j.scott@iop.kcl.ac.uk
Objective:
This study explored the utility of Health Belief Models (HBM) in explaining medication adherence in subjects with severe affective disorders.
Method:
Well-established measuring instruments, with confirmed reliability and validity, were used to assess each component of two HBMs and adherence to mood-stabilising medication in 98 subjects with either bipolar (805 subjects) or unipolar disorders.
Results:
About 30% of subjects met criteria for partial adherence to medication. Demographic and diagnostic variables did not predict adherence status. Subjects' beliefs about themselves and their control over the disorder were more important than side-effects in predicting medication adherence. Self-reported assessments were predictive of admission to hospital in the year after the interview.
Conclusion:
Although the study has a number of methodological limitations, the results suggest that clinical assessment of components of HBMs may improve the detection of patients at risk of non-adherence to mood-stabilising medication.