At the end of the education program, the learner (nurse) will be able to:
1. List and identify characteristics of various bipolar patients which can put them at higher risk for nonadherence to treatment. These may include, but are not limited to: adverse effects of medication, complex medication regimens, negative patient attitudes to medication, poor insight, rapid-cycling BD, comorbid substance misuse and a poor therapeutic alliance (Jawad, et al., 2018, par.1). These may also include a lack of outside emotional support from friends and caregivers, unstable living conditions, low levels of motivation to improve mental health, and low levels of health literacy. Weight gain and cognitive effects were the most frequently cited reasons for noncompliance (Johnson, et al., 2007).
2. Evaluate different strategies to enhance compliance to treatment. This may include taking the time to communicate with patients, creating a treatment plan with the patient and anticipating potential problems which might occur, discussing side effects and keeping open lines of communication to discuss medication changes and ways to manage them, and also plans to address outside factors influencing medication adherence, including treatment for comorbid substance abuse of financial support to find alternative occupations or living conditions (Jawad, et al., 2018). Email and telephone consultations to check in on patients as reminders may also be useful.
3. The nurse will be able to analyze why treatment adherence is so important, including how a lack of medication adherence is associated with a higher rate of relapse, poorer treatment outcomes, and further cognitive and socio-economic decline on the part of patients (Jawad, et al., 2007). Honesty is also important in the patient-provider relationship and a failure of patients to be honest about following treatment guidelines could be an indication of more serious problems down the road in the future.
References
Jawad, I., Watson, S., Haddad, P. M., Talbot, P. S., & McAllister-Williams, R. H. (2018).
Medication nonadherence in bipolar disorder: a narrative review.Therapeutic Advances in Psychopharmacology,8(12), 349363. https://doi.org/10.1177/2045125318804364
Johnson, F. R., Ozdemir, S., Manjunath, R., Hauber, A. B., Burch, S. P., & Thompson, T. R.
(2007). Factors that affect adherence to bipolar disorder treatments: a stated-preference approach.Medical Care,45(6), 545552. https://doi.org/10.1097/MLR.0b013e318040ad90
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