You are here

  • Home
  • Archive
  • Volume 9, Issue 2
  • Mapping of modifiable barriers and facilitators of medication adherence in bipolar disorder to the Theoretical Domains Framework: a systematic review protocol

Article Text

Article menu

Download PDFPDF

XML
Mental health
Protocol
Mapping of modifiable barriers and facilitators of medication adherence in bipolar disorder to the Theoretical Domains Framework: a systematic review protocol
  1. Asta Ratna Prajapati1,2,
  2. Alexandra Lelia Dima3,
  3. Allan B Clark4,
  4. Claire Gant5,
  5. Chris Gibbons6,
  6. Richard Gorrod5,
  7. George Mosa7,
  8. Sion Scott2,
  9. Fujian Song4,
  10. Bonnie Teague7,
  11. Michael J Twigg2,
  12. Jon Wilson7,
  13. Debi Bhattacharya2
  1. 1 Pharmacy, Norfolk and Suffolk NHS Foundation Trust, Norwich, UK
  2. 2 School of Pharmacy, University of East Anglia, Norwich, UK
  3. 3 Health Services and Performance Research EA 7425 HESPER, University Claude Bernard Lyon 1, Lyon, France
  4. 4 Norwich Medical School, Norwich, UK
  5. 5 Patient and Carer Representatives, Norwich, UK
  6. 6 Faculty of Medicine, Harvard Medical School, Boston, Massachusetts, USA
  7. 7 Norfolk and Suffolk NHS Foundation Trust, Norwich, UK
  1. Correspondence to Asta Ratna Prajapati; asta.prajapati{at}nsft.nhs.uk

Abstract

Introduction People with bipolar disorder require long-term treatment but it is estimated that 40% of these people do not adhere to prescribed medication regimens. Non-adherence increases the risk of relapse, hospitalisation and suicide. Some evidence syntheses report barriers to mental health treatment adherence but rarely delineate between modifiable and non-modifiable barriers. They also fail to distinguish between the patients’ perspective and that of other stakeholders such as clinicians despite of their different understanding and priorities about adherence. Facilitators of adherence, which are also important for informing adherence intervention design, are also lacking from syntheses and few syntheses focus on medications for bipolar disorder.

This systematic review aims to identify modifiable barriers and facilitators (determinants) of medication adherence in bipolar disorder. We also plan to report determinants of medication adherence from perspectives of patients, carers, healthcare professionals and other third parties. A unique feature of this systematic review in the context of mental health is the use of the Theoretical Domains Framework (TDF) to organise the literature identified determinants of medication adherence.

Methods and analysis The protocol adheres to Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols and ENhancing Transparency in REporting the synthesis of Qualitative research (ENTREQ) guidelines. This review will include both qualitative and quantitative primary studies exploring determinants of medication adherence in bipolar disorder. We will search the following databases using a preplanned strategy: CINAHL, Cochrane Library (CENTRAL), Embase, LiLACS, Medline, PsychINFO, PubMed without date restrictions. We will report the quality of included studies. We will use framework synthesis using the TDF as an a priori ‘framework’. We will map the literature identified modifiable determinants to the domains of TDF.

Ethics and dissemination Ethical approval is not required as primary data will not be collected. The results will be disseminated through a peer-reviewed publication.

PROSPERO registration number CRD42018096306.

  • determinant
  • compliance
  • concordance
  • psychotropic drug
  • mood stabilizer
  • mental health

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

https://doi.org/10.1136/bmjopen-2018-026980

Statistics from Altmetric.com

    Request Permissions

    If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.

    View Full Text

    Footnotes

    • Contributors All authors (ARP, AD, ABC, CGa, CGi, RG, GM, SS, FS, BT, MJT, JW and DB) helped conceive the study, reviewed the protocol and provided intellectual critique. ARP and DB designed and wrote the protocol. ARP registered the study with PROSPERO. All authors (ARP, AD, ABC, CGa, CGi, RG, GM, SS, FS, BT, MJT, JW and DB) have approved the publication of this protocol.

    • Funding This research is a part of the Clinical Doctoral Research Fellowship program funded by Health Education England / National Institute of Health Research. AD has been funded by the European Commission (MSCA-IF n°706028) during the preparation of this manuscript.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Correction notice This article has been corrected since it was published. Middle name and affiliation has been updated for Dr Alexandra Lelia Dima. Funding information has also been updated.

    • Patient consent for publication Not required.