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LAI Plus Counseling Improves Adherence, Symptoms in Patients with Bipolar Disorder
Long-acting injectable antipsychotic medication combined with psychosocial intervention improved medication adherence and symptoms in patients with bipolar disorder, according to a study published in Primary Care Companion for CNS Disorders.
"In spite of the adherence advantages for long-acting injectable meds, simply switching individuals to them may not be enough to sustain long-term behavioral change," said lead author Martha Sahatovic, MD, director of the Neurobiological and Behavioral Outcomes Center at Case Western Reserve University School of Medicine and University Hospitals Cleveland Medical Center.
"Our pilot trial combined the long-acting injectable with a brief behavioral approach called customized adherence enhancement."
The prospective, uncontrolled trial included 30 patients with bipolar disorder and poor medication adherence. Study participants received customized adherence enhancement counseling provided by a social worker at an initial baseline session followed by monthly sessions over the next 6 months. Counseling was delivered at the same visit patients received administration of the long-acting injectable aripiprazole.
Customized adherence enhancement counseling aims to address a patient’s specific medication adherence barriers, researchers explained, such as a lack of education about medication, communication problems with providers, or poor medication routines.
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From the time of study screening to 24 weeks, the proportion of missed medications in the past week improved significantly from 50.1% to 16.9%. The proportion of missed medication in the past month improved from 40.6% to 19.2%.
Over the 6 months of the study, participants’ bipolar disorder symptoms and global psychopathy significantly decreased, researchers reported. Meanwhile, functioning significantly improved.
Participants deemed the customized adherence enhancement intervention highly acceptable.
“Overall,” said Dr Sajatovic, “our findings suggest that a personalized intervention to address adherence barriers combined with long-acting injectable [medication] can significantly improve outcomes in high-risk individuals with bipolar disorder.”
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