{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,11]],"date-time":"2026-02-11T18:43:00Z","timestamp":1770835380264,"version":"3.50.1"},"reference-count":48,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2015,9,3]],"date-time":"2015-09-03T00:00:00Z","timestamp":1441238400000},"content-version":"vor","delay-in-days":2,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000025","name":"National Institute of Mental Health (NIMH)","doi-asserted-by":"crossref","award":["NIMH 1R01MH093321-01A1"],"award-info":[{"award-number":["NIMH 1R01MH093321-01A1"]}],"id":[{"id":"10.13039\/100000025","id-type":"DOI","asserted-by":"crossref"}]},{"name":"Clinical and Translational Science Award (CTSC)","award":["UL1TR 00043"],"award-info":[{"award-number":["UL1TR 00043"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Bipolar Disorders"],"published-print":{"date-parts":[[2015,9]]},"abstract":"<jats:sec><jats:title>Objectives<\/jats:title><jats:p>This analysis of screening and baseline data from an ongoing trial examined self\u2010report versus automated adherence monitoring and assessed the relationship between bipolar disorder (BD) symptoms and adherence in 104 poorly adherent individuals.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Adherence was measured with the Tablets Routine Questionnaire (TRQ) and the Medication Event Monitoring System (MEMS). Symptoms were measured with the Montgomery\u2013\u00c5sberg Depression Rating Scale (MADRS), the Young Mania Rating Scale (YMRS), and the Brief Psychiatric Rating Scale (BPRS).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The mean age of the sample was 46.3\u00a0years [standard deviation (SD)\u00a0=\u00a09.41 years], with 72% (n\u00a0=\u00a075) women and 71% (n\u00a0=\u00a074) African American subjects. Adherence improved from screening to baseline, with a mean missed drug proportion measured by TRQ of 61.43% (SD\u00a0=\u00a026.48%) versus a baseline mean of 46.61% (SD\u00a0=\u00a030.55%). The mean proportion of missed medication using MEMS at baseline was 66.43% (SD\u00a0=\u00a030.40%). The correlation between TRQ and MEMS was 0.47. The correlation between a single <jats:italic>index<\/jats:italic> drug and all BD medications was 0.95. Symptoms were generally positively correlated with TRQ (worse adherence\u00a0=\u00a0more severe symptoms), but in most instances was only at a trend level (p\u00a0&gt;\u00a00.05), with the exception of the correlations between baseline TRQ and MADRS and BPRS, which were positive (<jats:italic>r\u00a0<\/jats:italic>=<jats:italic>\u00a0<\/jats:italic>0.20 and <jats:italic>r\u00a0<\/jats:italic>=<jats:italic>\u00a0<\/jats:italic>0.21, respectively) and significant (p\u00a0\u2264\u00a00.05).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>In patients with BD, monitoring increased adherence by 15%. MEMS identified 20% more non\u2010adherence than self\u2010report. Using a standard procedure to identify a single <jats:italic>index<\/jats:italic> drug for adherence monitoring may be one way to assess global adherence in patients with BD receiving polypharmacy treatment. Greater BD symptom severity may be a clinical indicator to assess for adherence problems.<\/jats:p><\/jats:sec>","DOI":"10.1111\/bdi.12326","type":"journal-article","created":{"date-parts":[[2015,9,4]],"date-time":"2015-09-04T15:37:12Z","timestamp":1441381032000},"page":"653-661","source":"Crossref","is-referenced-by-count":25,"title":["Symptom severity, self\u2010reported adherence, and electronic pill monitoring in poorly adherent patients with bipolar disorder"],"prefix":"10.1111","volume":"17","author":[{"given":"Martha","family":"Sajatovic","sequence":"first","affiliation":[{"name":"Department of Psychiatry Case Western Reserve University School of Medicine Cleveland OH USA"},{"name":"University Hospitals Case Medical Center Neurological and Behavioral Outcomes Center Cleveland OH USA"},{"name":"Department of Neurology Case Western Reserve University School of Medicine Cleveland OH USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jennifer B","family":"Levin","sequence":"additional","affiliation":[{"name":"Department of Psychiatry Case Western Reserve University School of Medicine Cleveland OH USA"},{"name":"University Hospitals Case Medical Center Neurological and Behavioral Outcomes Center Cleveland OH USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Johnny","family":"Sams","sequence":"additional","affiliation":[{"name":"Department of Psychiatry Case Western Reserve University School of Medicine Cleveland OH USA"},{"name":"University Hospitals Case Medical Center Neurological and Behavioral Outcomes Center Cleveland OH USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kristin A","family":"Cassidy","sequence":"additional","affiliation":[{"name":"Department of Psychiatry Case Western Reserve University School of Medicine Cleveland OH USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kouri","family":"Akagi","sequence":"additional","affiliation":[{"name":"Department of Psychiatry Case Western Reserve University School of Medicine Cleveland OH USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michelle E","family":"Aebi","sequence":"additional","affiliation":[{"name":"University Hospitals Case Medical Center Neurological and Behavioral Outcomes Center Cleveland OH USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Luis F","family":"Ramirez","sequence":"additional","affiliation":[{"name":"Department of Psychiatry Case Western Reserve University School of Medicine Cleveland OH USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Steven A","family":"Safren","sequence":"additional","affiliation":[{"name":"Department of Psychiatry Harvard Medical School\/Massachusetts General Hospital Boston MA USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Curtis","family":"Tatsuoka","sequence":"additional","affiliation":[{"name":"University Hospitals Case Medical Center Neurological and Behavioral Outcomes Center Cleveland OH USA"},{"name":"Department of Neurology Case Western Reserve University School of Medicine Cleveland OH USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2015,9,3]]},"reference":[{"issue":"4","key":"e_1_2_8_2_1","first-page":"1","article-title":"Practice guideline for the treatment of patients with bipolar disorder (revision)","volume":"159","author":"American Psychiatric Association","year":"2002","journal-title":"Am J Psychiatry"},{"key":"e_1_2_8_3_1","unstructured":"KeckPJr PerlisR OttoMet\u00a0al.The Expert Consensus Guidelines: Treatment of Bipolar Disorder 2004. 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