Research Activities, March 2012: Mental Health: Adherence to bipolar medications may also promote adherence to antiretroviral therapy
Individuals with bipolar disorder and other severe mental illnesses are more likely to have higher rates of HIV infection compared to the general population, possibly due to impulsive behaviors or substance use disorders. Individuals with bipolar disorder usually require long-term treatment with various psychotropic medications. Patients with bipolar disorder, who adhere to their bipolar medications, are also more likely to adhere to their antiretroviral treatment for HIV infection, suggests a new study using prescription refill data. It retrospectively examined data from Medicaid claims in 8 States from 2001 to 2004. A total of 10,971 beneficiaries were identified as having both bipolar disorder and HIV infection. The final sample included 1,687 patients.
During a mean observation period of 32 months, antiretrovirals were refilled in 72 percent of the months.
Bipolar medications were refilled in 55 percent of the months. There were higher rates of antiretroviral adherence when patients adhered to their bipolar medications. For example, when a bipolar medication was not filled in the prior month, the antiretroviral fill rate was 65 percent in the subsequent month, compared to a 78 percent antiretroviral fill when a bipolar medication was refilled the prior month. Antiretroviral fill rates were higher for men and for beneficiaries 50 years of age and older. When there was a coexisitng substance use disorder, the antiretroviral fill rate was significantly lower.
This study was funded in part by the Agency for Healthcare Research and Quality (HS16097) to Rutger University's Center for Research and Education on Mental Health Therapeutics, part of AHRQ's Centers for Education and Research on Therapeutics (CERTs) Program. For more information on the CERTs program, visit http://www.certs.hhs.gov.
See "Bipolar medication use and adherence to antiretroviral therapy among patients with HIV-AIDS and bipolar disorder," by James T. Walkup, Ph.D., Ayse Akincigil, Ph.D., Sujoy Chakravarty, Ph.D., and others in Psychiatric Services 62(3), pp. 313-316, 2011.