A nurse-led psychoeducational program BalancingMySwing improves medication adherence among Taiwanese Han-Chinese with bipolar II disorder

Abstract

ABSTRACT Introduction: The beneficial effects of combined psychosocial and pharmacological treatments for bipolar disorder have been widely documented. However, little research has specifically looked at bipolar II disorder (BP-II), despite it being the most common variant. Methods: This study used a matched-pairs two-group pretest–posttest design to compare the effectiveness of the 10-session weekly “BalancingMySwing” (BMS) program with treatment as usual in a Han Chinese cohort with bipolar II disorder. Twenty-four participants from a medical center in southern Taiwan with a DSM-IV diagnosis of BP-II were purposively recruited and divided into two matched-pair groups for treatment feasibility. Primary outcome indicators were medication adherence and mood symptoms, which were assessed at baseline and posttreatment. Medication adherence was assessed using the self-reported Medication Adherence Rating Scale (MARS). Mood symptoms were assessed by a blinded rater using the 11-item Young Mania Rating Scale (YMRS) and 17-item Hamilton Depression Rating Scale (HDRS). Results: After 10 weeks, a significant group × time interactions for the MARS scores indicated that improvements in medication adherence were greater in the BMS group than in the Treatmentas- Usual (TAU) group. However, there were no significant time effects or group differences for the HDRS or the YMRS scores in either group. Conclusion: Our data support the potential beneficial effects of the nurse-led psychoeducational program on medication adherence in Taiwanese Han Chinese with BP-II. Several limitations and barriers to implementation that might confound results are discussed. Future studies with larger samples and longer follow-ups are needed.