Effectiveness of adherence therapy in patients with bipolar disorder: A randomized controlled study

Background: Treatment adherence improves the quality of life and functional outcomes in patients with bipolar disorder (BD) by supporting effective disease management and fostering the development of self-esteem and self-efficacy. This study aimed to determine the effect of Adherence Therapy (AT) on medication adherence (MA), self-efficacy, and self-esteem in patients diagnosed with BD. Subjects and Methods: This randomized controlled study was conducted with patients diagnosed with BD admitted to the psychiatry outpatient clinic of an Application and Research Hospital in Türkiye. The participants were randomly assigned to either an intervention group (n = 31), who received AT individually, or a control group (n = 30), who continued with their routine outpatient clinic follow-up. Data were collected using the Patient Descriptive Questionnaire, the Morisky Medication Adherence Scale (MMAS), the Self-Efficacy Scale (SES), and the Coopersmith Self-Esteem Inventory -Adult Form (CSEI). Results: There was a significant difference in the MMAS scores, which assess MA, between the intervention and control groups after the AT intervention (p < 0.01). Logistic regression analysis revealed that participants in the intervention group had a significantly lower likelihood of poor MA than those in the control group (OR = 0.060; p < 0.01). An increasing trend was observed in the SES scores of the intervention group; however, this difference was not statistically significant. The CSEI scores increased significantly in the intervention group, but no significant difference was found between the groups. Conclusions: The AT administered to patients with BD played a role in increasing patients’ adherence to treatment. The results of this study suggest that it is important for mental health professionals to use evidence-based strategies to improve patients’ MA.