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Continuity of Care and Medication Adherence among Youth with Bipolar Spectrum Disorders Enrolled in a Large Pragmatic Study

Klein, Christina
http://rave.ohiolink.edu/etdc/view?acc_num=ucin16497632534025

Abstract Details

2022, PhD, University of Cincinnati, Education, Criminal Justice, and Human Services: Health Education.
Abstract AN ABSTRACT OF THE DISSERTATION FOR THE DOCTOR OF PHILOSOPHY DEGREE IN HEALTH PROMOTION AND EDUCATION, PRESENTED ON AT THE UNIVERSITY OF CINCINNATI, CINCINNATI, OH TITLE: Continuity of Care and Medication Adherence among Youth with Bipolar Spectrum Disorders Enrolled in a Large Pragmatic Study DOCTORAL COMMITTEE MEMBERS: Dr. Laura A. Nabors (chair), Dr. Rebecca A. Vidourek, and Dr. Melissa P. DelBello. Study One Abstract Introduction: The primary aim of this study was to examine variables, such as symptom severity and insurance status, related to continuity of care (follow-up visits, hospitalization) for youth with bipolar spectrum disorders who are overweight/obese. Methods: A secondary data analysis of data collected in MOBILITY was performed. All MOBILITY participants enrolled from November 5, 2015 through December 1, 2018 in the Midwest Region (N = 610) were included in analyses. Results: Participants enrolled from an inpatient hospital setting had fewer follow-up visits than those enrolled from an outpatient setting. Patients enrolled on an inpatient vs. outpatient setting were analyzed separately. Among patients enrolled from an outpatient setting, having public health insurance was associated with having higher numbers of psychiatric follow-up visits. Outpatients with lower CGI-S scores (less severe) at baseline had more follow-up visits. Higher CGI-S scores were associated with increased number of hospitalizations for those enrolled in outpatient settings. Outpatients with higher CGI-S scores and more follow-up visits had fewer hospitalizations than those with fewer follow-up visits. For participants enrolled on an inpatient setting, younger age was associated with higher number of hospitalizations. Conclusions: This study documented differences in continuity of care among the MOBILITY sample. Future studies are needed to determine if additional patient-level variables contribute to gaps in continuity of care so interventions can be targeted to those most vulnerable. Study Two Abstract The primary purpose of this study was to examine differences in SGA medication adherence among youth with bipolar spectrum disorders who were overweight/obese, before and since the COVID-19 pandemic. Methods: A secondary data analysis of data collected in MOBILITY was performed. All MOBILITY patient/caregiver dyads (N = 376) who completed tablet assessments for the Month 6 MOBILITY visit between March 1, 2019 and April 30, 2021 were included in analyses. Results: Before COVID-19, patients reported they missed 8.8% of prescribed doses/week, while caregivers reported patients missed 8.05% doses/week. Since COVID-19, patients reported missing 11.95% doses/week, and caregivers reported patients missed 4.63% doses/week. There were no significant differences in medication adherence rates before and since COVID-19 among patients or caregivers. The most frequently reported barrier to medication adherence among patients and caregivers in both time frames was forgetting to take medications. According to patients, caregiver assistance in taking medication may improve mediation adherence. Discussion: Patient and caregiver report of adherence rates since COVID-19 differed, but reports of rates by both groups were similar before the pandemic. Future studies are needed to determine if adherence rates changed over time during the pandemic and to determine patient- and caregiver-acknowledged factors that facilitate adherence to medication regimens.
Laura Nabors, Ph.D. (Committee Member)
Rebecca Vidourek, Ph.D. (Committee Member)
Melissa Delbello, M.D. (Committee Member)
114 p.
Health Care
bipolar disorder; children and adolescents; continuity of care; medication adherence

Recommended Citations

Citations

  • Klein, C. (2022). Continuity of Care and Medication Adherence among Youth with Bipolar Spectrum Disorders Enrolled in a Large Pragmatic Study [Doctoral dissertation, University of Cincinnati]. OhioLINK Electronic Theses and Dissertations Center. http://rave.ohiolink.edu/etdc/view?acc_num=ucin16497632534025

    APA Style (7th edition)

  • Klein, Christina. Continuity of Care and Medication Adherence among Youth with Bipolar Spectrum Disorders Enrolled in a Large Pragmatic Study. 2022. University of Cincinnati, Doctoral dissertation. OhioLINK Electronic Theses and Dissertations Center, http://rave.ohiolink.edu/etdc/view?acc_num=ucin16497632534025.

    MLA Style (8th edition)

  • Klein, Christina. "Continuity of Care and Medication Adherence among Youth with Bipolar Spectrum Disorders Enrolled in a Large Pragmatic Study." Doctoral dissertation, University of Cincinnati, 2022. http://rave.ohiolink.edu/etdc/view?acc_num=ucin16497632534025

    Chicago Manual of Style (17th edition)

ucin16497632534025
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This open access ETD is published by University of Cincinnati and OhioLINK.