The effect of comprehensive individual motivational-educational program on medication adherence in elderly patients with bipolar disorders: An experimental study

The number of older adults with bipolar disorder is increasing and medication non‑adherence is a major problem that negatively impacts the course of bipolar disorder. This study aimed to determine the effect of a comprehensive individual motivational‑educational program on medication adherence in elderly patients with bipolar disorder.

An experimental study with pretest‑posttest repeated measures with a control group was conducted on two groups of 62 elderly people with bipolar disorders hospitalized at Ibn Sina Hospital in Mashhad, Northeast Iran, 2019. For the elderly in the intervention group, a comprehensive motivational‑educational program was administered for one month (four 30–45 minute sessions), and for the elderly in the control group, routine clinical care was performed. Medication adherence in both elderly groups was measured before, immediately after, one and two months after the intervention. Data were analyzed by SPSS statistical software (version 16) using descriptive statistics and independent t‑test, Mann‑Whitney, paired t‑test, repeated measures analysis of variance (ANOVA), and Chi‑square tests.

The mean age of elderlies in the intervention and control groups were 69.03 ± 5.75 and 68.50 ± 6.73 years, respectively. Regardless of the groups to which the patients were assigned, a significant difference in medication adherence scores was observed during the study period (time effect; P < 0.001). Also, the medication adherence score was significantly lower in the intervention group, compared to the control group (group effect; P < 0.001). Also, there was a group time interaction between the medication adherence score and the time of evaluation (P < 0.001).

The results of the present study confirm the positive effect of a comprehensive educational‑motivational program on improving medication adherence in elderly patients with bipolar disorder.