Bipolar disorder can be a debilitating illness. It is comprised of episodes of mania and depression that can be severe. Medication is the most effective treatment for bipolar disorder, but many people do not take their medication as prescribed. This can lead to less effective treatment, withdrawals and relapse. There are many ways practitioners are trying in an attempt to increase medication adherence. One way is to use mobile technology. A recent study looked at how effective the use of mobile tech like apps and SMS are in helping patients take their medication as prescribed.
Failing to take medication exactly as prescribed is referred to as medication noncompliance or medication nonadherence, and is a prominent problem in the attempt to treat bipolar disorder. Up to 60% of people with bipolar disorder do not take their medication as prescribed. This does not include occasionally forgetting one day. Many people skip multiple doses for long periods, whether on purpose or by accident. Others discontinue taking medication entirely. Some will take their medication, but not exactly as prescribed. For example, some people may take their medication at the wrong time of day or without food when medication is supposed to be taken with food.
There are many reasons people with bipolar disorder discontinue taking medications. Some of the most common are:
- Lack of awareness of how effective a medication is or how bad their illness is
- Having a negative attitude towards taking medication in general or because of the stigma associated with taking psychotropic medications
- Side effects like weight gain, drowsiness, gastrointestinal distress and decreased libido
- Concurrent substance use disorder or “self-medicating”
- Not having the resources to purchase medication
- Having a poor relationship with the prescriber
- Lag time between initial prescription and when the medication becomes effective
- Feeling that the medication is not working or not needed
There are several strategies used to help patients be more adherent to their medication. For example:
- Educating people about their disorder and the need for medication
- Using reminders like calendar updates and alarms
- Providing discounts for medications
- Encouraging more social support from friends and family
- Watching the patient take their medication
New research is emerging testing the effectiveness of using mobile technology on tablets or smartphones to increase medication compliance. It has been shown that mobile technology helps people with schizophrenia to be more compliant. A new research review looked at nine studies to find whether or not this may be the case for mood disorders as well.
Some of the ways in which mobile technology were used included phone calls, text messages, web-based surveys and the smartphone app MedLink. The average length of the study was 8 weeks with patients reporting in weekly, daily or multiple times a day.
The studies showed promising results. Two studies showed that SMS intervention improved both medication adherence and presence at clinical appointments. One study showed that the use of the MedLink smartphone app improved adherence by 91% by the end of the study. Yet another study showed that a combination of SMS, patient education and mood tracking increased adherence to at least 67%.
This research shows that it is possible to increase medication adherence using mobile technology. However, the studies are pilot studies and some had severe dropout rates or small samples. More research will need to be done to see exactly how effective mobile technology can be at helping people take their medication as prescribed.
Image credit: Sarah Joy