Document Type : Original Article


1 Geriatric Care Research Center, Department of Geriatric Nursing, School of Nursing, North Khorasan University of Medical Sciences, Bojnurd, Iran

2 School of Nursing, North Khorasan University of Medical Sciences, Bojnurd, Iran

3 Geriatric Care Research Center, Department of Medical‑Surgical Nursing, School of Nursing, North Khorasan University of Medical Sciences, Bojnurd, Iran


BACKGROUND: The number of older adults with bipolar disorder is increasing and medication
non‑adherence is a major problem that negatively impacts the course of bipolar disorder. This study
aimed to determine the effect of a comprehensive individual motivational‑educational program on
medication adherence in elderly patients with bipolar disorder.
MATERIALS AND METHOD: An experimental study with pretest‑posttest repeated measures with a
control group was conducted on two groups of 62 elderly people with bipolar disorders hospitalized
at Ibn Sina Hospital in Mashhad, Northeast Iran, 2019. For the elderly in the intervention group, a
comprehensive motivational‑educational program was administered for one month (four 30–45 minute
sessions), and for the elderly in the control group, routine clinical care was performed. Medication
adherence in both elderly groups was measured before, immediately after, one and two months after
the intervention. Data were analyzed by SPSS statistical software (version 16) using descriptive
statistics and independent t‑test, Mann‑Whitney, paired t‑test, repeated measures analysis of
variance (ANOVA), and Chi‑square tests.
RESULTS: The mean age of elderlies in the intervention and control groups were 69.03 ± 5.75 and
68.50 ± 6.73 years, respectively. Regardless of the groups to which the patients were assigned, a
significant difference in medication adherence scores was observed during the study period (time
effect; P < 0.001). Also, the medication adherence score was significantly lower in the intervention
group, compared to the control group (group effect; P < 0.001). Also, there was a group time interaction
between the medication adherence score and the time of evaluation (P < 0.001).
CONCLUSION: The results of the present study confirm the positive effect of a comprehensive
educational‑motivational program on improving medication adherence in elderly patients with bipolar


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