| Publication Abstract Display | | Type: Poster | | Title: Predictors of psychotropic medication non-adherence among HIV+ individuals living with bipolar disorder. | | Authors: Blackstone K, Kwan S, Gouaux B, Poquette A, Montoya J, Rooney A, Moore DJ, and the HNRP Group | | Date: 02-12-2014 | | Abstract:Objective: HIV infection and bipolar disorder (HIV/BD) are highly comorbid and lead to fronto-striatal disruption, emotional dysregulation and neurocognitive impairment. Psychiatric and cognitive factors have been linked to antiretroviral nonadherence; however, predictors of psychotropic adherence among HIV+ individuals with psychiatric comorbidities have not been explored. The present study evaluates predictors of psychotropic nonadherence among HIV/BD individuals.
Participants and Methods: Psychotropic medications of 50 HIV/BD participants were tracked for 30 days using Medication Event Monitoring Systems (MEMS). Participants completed neurocognitive, neuromedical, and psychiatric batteries.
Results: Mean psychotropic adherence rate was 78%, with 56% of participants achieving ≥90% adherence by MEMS. Younger age, greater current depressive symptoms, younger onset of depressive symptoms, greater number of previous psychiatric hospitalizations and suicide attempts, poorer time-based prospective memory, worse executive functions and working memory, and more negative attitudes and self-beliefs toward medications were univariately predictive of worse overall psychotropic adherence (p<.10). A multivariable model, including a representative variable from each area assessed (i.e., age, current depressive symptoms, executive functions, medication attitudes and self-beliefs), accounted for 27% of the variance in psychotropic adherence (p<0.003), in which current depressive symptoms and more negative attitudes toward medications were uniquely associated with poorer psychotropic adherence.
Conclusions: Greater current depressive symptoms and negative beliefs regarding medications may be the strongest indicators of poor psychotropic adherence among HIV/BD individuals, even when accounting for other psychiatric and neurocognitive factors. Adherence interventions in HIV/BD may benefit from tailoring approaches to mood stabilization and education on the role of psychotropic medications. |
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