Factors associated with treatment non-adherence among patients with bipolar disorder in Vietnam

To identify factors associated with treatment non-adherence among patients with bipolar disorder in Vietnam.

Outpatients with bipolar disorder receiving treatment at the Bach Mai Hospital, Vietnam between November 2023 and August 2024 were recruited using convenience sampling. Medication adherence was measured using the eight-item Morisky Medication Adherence Scale (MMAS-8). The adherence and non-adherence groups were compared. Generalised multiple linear regression was conducted to assess the effects of relevant factors on the MMAS-8 score. Logistic regression analysis was conducted to identify factors associated with non-adherence.

Of 121 patients with bipolar disorder included in the analysis, 53 (43.8%) were classified as treatment adherence and 68 (56.2%) as non-adherence. In the multivariable analysis, non-adherence status was positively associated with male sex (odds ratio [OR] = 5.837, p = 0.006), lower education level (OR = 3.587, p = 0.023), and receipt of >2 medications (OR = 6.832, p = 0.002), and negatively associated with married status (OR = 0.149, p = 0.002) and family encouragement (OR = 0.214, p = 0.024). In the non-adherence group, MMAS-8 scores were negatively correlated with male sex (β = -0.565, p = 0.001), distance to the clinic (β = -0.002, p = 0.038), and number of medications (β = -1.927, p = 0.030), and positively correlated with family companion during examinations (β = 0.598, p = 0.016), family reminders to take medication (β = 0.585, p = 0.019), and family management of medication (β = 0.636, p = 0.036).

Among patients with bipolar disorder, treatment non-adherence is associated with male sex and number of prescribed medications. Family support is important for treatment adherence; efforts to foster family involvement may improve treatment adherence.