Compliance with outpatient lithium therapy

This study was conducted to identify factors that influence compliance in patients being treated with lithium carbonate and regularly scheduled supportive clinic appointments for major affective disorders. The researcher examined the predictive value of elements of the Health Belief Model relative to patient compliance, the demographic characteristics of patients, and the effects of patient mood and type of treatment on patient compliance. Patient compliance was operationally defined as serum lithium level within a recommended therapeutic range and attendance at 75 percent or more of regularly scheduled clinic appointments for six months prior to the study. Fifty patients (67%) were compliant with both indices specified by the research, and only three patients (4%) were noncompliant with both indices. Lithium compliance was significantly greater among married patients and patients with higher levels of education. Appointment-keeping compliance was positively associated with individual therapy and increased patients' perceptions of continuity, and negatively correlated with patients' perceptions of increased costs of treatment. The study demonstrates the complexity of the issue of patient compliance with the long-term treatment of primary affective disorders and supports the need for additional research. While some findings suggest interventions to improve patient adherence, scrutiny and testing of these strategies to promote compliance is necessary to determine their effectiveness.