Promoting medication adherence among patients with bipolar disorder: A multicenter randomized controlled trial of a multifaceted intervention

A. H. Pakpour, A. Modabbernia, Chung-Ying Lin, M. Saffari, M. Ahmadzad Asl, T. L. Webb

Research output: Journal article publicationJournal articleAcademic researchpeer-review

15 Citations (Scopus)


Background The present research aimed to investigate the efficacy of a multifaceted intervention that included motivational interviewing (MI) and psychoeducation in improving medication adherence (MA) among patients with bipolar disorder (BD). Method A multicenter, cluster randomized, observer-blind, controlled, parallel-group trial was conducted in ten academic centers in Iran. Patients with BD were randomly assigned to the experimental group (EXP; n = 136) or the usual care group (UC; n = 134). The EXP group received five sessions of MI and psychoeducation together with their family members. The primary outcome measure was changes in scores on the Medication Adherence Rating Scale from baseline to 6 months post-intervention. Other outcome measures included serum levels of mood stabilizers, clinical symptoms, quality of life, as well as measures of intention, beliefs about medicine, perceived behavioral control, automaticity, action and coping planning, and adverse reactions. Results Medication adherence improved over time in both groups, but patients in the EXP group improved more (baseline score: 6.03; score at the sixth month: 9.55) than patients in the UC group (baseline score: 6.17; score at the sixth month: 6.67). In addition, patients in the EXP group showed greater improvement than patients in the UC group in almost all secondary outcomes 6 months following the intervention. Conclusions Multifaceted interventions that include motivational-interviewing and psychoeducation can significantly improve MA and clinical and functional outcomes in patients with BD. Trial Registration Number: The trial was registered with database (NCT02241863)
Original languageEnglish
Pages (from-to)2528-2539
Number of pages12
JournalPsychological Medicine
Issue number14
Publication statusPublished - 1 Oct 2017


  • Adherence
  • bipolar disorder
  • mood stabilizer
  • motivational interviewing
  • psychoeducation

ASJC Scopus subject areas

  • Applied Psychology
  • Psychiatry and Mental health

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