The effect of adherence therapy administered to patientsdiagnosedwith bipolar disorder on medication adherence, self-efficacy and self-esteem

Introduction and aim: Treatment adherence is important in improving self-esteem and self-efficacy in patients with bipolar disorder (BD). This study was conducted to determine the effect of Adherence Therapy (AT) administered to patients diagnosed with bipolar disorder on medication adherence, self-efficacy and self-esteem.Materials and methods: The study was designed as pretest - posttest with a control group and its population consisted of 288 registered patients who were diagnosed with bipolar disorder as per the DSM-5 criteria at the Psychiatry Outpatient Clinic of Sivas Cumhuriyet University, Application and Research Hospital. No sample was selected and a total of 74 patients, 38 in the investigational group and 36 in the control group, who met the inclusion criteria were included and the study was completed with 61 patients. The AT was administered to the patients in the investigational group in three sessions held once a week, each lasting between 40 and 90 minutes, while the control group continued to attend their routine outpatient clinic appointments. The study data were collected between February and November 2017 using a Descriptive Questionnaire, the Morisky Medication Adherence Scale, the Self-efficacy Scale, and the Coopersmith Self-esteem Inventory (Adult Form). The data were analyzed using t-test, McNemar test and chi-square analysis in both dependent and independent groups. Results: A significant difference was found between the mean MMAS scores of the investigational and control group patients after the AT (p<0.01). The mean CSEI-AD scores of the investigational group increased after the therapy (p<0.05), but there was no significant difference between the investigational and control groups (p>0.05). The mean SES scores of the patients also did not differ significantly (p>0.05).Conclusion: The AT administered to patients with BD for the first time in Turkey was found to improve the patients' medication adherence. I was also found that although self-estem showed an increase in the interventional group, there was no difference with comparison to the control group. Psychiatric nurses need to use evidence-based strategies to improve medication adherence in patients with bipolar disorder and other mental disorders.Keywords: Self-esteem, Bipolar disorder, Self-efficacy, Psychiatric nurse, Treatment adherence, Adherence Therapy.