The effect of motivational interviewing and telepsychiatric follow-up on medication adherence of patients with bipolar disorder: A randomized controlled trial

INTRODUCTION: This study was conducted to determine the effect of an individualized motivational interview-based program to improve medication adherence with a telepsychiatric complement (by telephone) on outpatients with bipolar disorder in follow-up at a community mental health center.
METHODS: A randomized controlled experimental study was conducted with 54 patients who were receiving care for bipolar disorder at a community mental health center post hospitalization. The data were collected using an information form, the Morisky Medication Adherence Scale (MMAS), and the Medication Adherence Rating Scale. A motivational, interview-based program to improve medication adherence consisting of 6 sessions and a total of 240–270 minutes was administered to the experimental group. After the program, SMS medication reminders were sent to the patients in the experimental group for 3 months. The scales were readministered to the experimental and control groups at the end of the third and sixth month to assess medication adherence. Variance analysis, significance test of difference between means, the Friedman test, the Mann-Whitney U test, a chi-squared test, and correlation analysis were used to evaluate the data.
RESULTS: The mean MMAS score in the experimental group was 2.96±0.69 before the program, 0.46±0.83 after 3 months, and 0.14±0.44 after 6 months. The difference in the medication adherence scores of the patients in the experimental group after the program and telephone follow-up was statistically significant (p<0.05). There was no significant change in the medication adherence level in the control group (p>0.05).
DISCUSSION AND CONCLUSION: The results indicated that the motivational interview and telepsychiatric follow-up techniques were successful and can be used to increase medication adherence of bipolar patients.