Medication adherence and its clinical and psychosocial correlates in inpatients with bipolar disorder in Vietnam: a cross-sectional study.

BACKGROUND AND OBJECTIVES: Medication adherence remains a major challenge in the long-term management of bipolar disorder. Both clinical and psychosocial factors may be associated with adherence behavior, yet data from low- and middle-income countries remain limited. This study aimed to examine medication adherence and its clinical and psychosocial correlates among inpatients with bipolar disorder in Vietnam. METHODS: A cross-sectional study was conducted among 90 inpatients diagnosed with bipolar disorder according to ICD-10 criteria at a central psychiatric hospital in Vietnam. Medication adherence was defined as taking ≥80% of prescribed medication during the maintenance phase. Demographic, clinical, and psychosocial variables were assessed. Univariate and multivariable logistic regression analyses were performed to identify factors associated with adherence. RESULTS: Overall, 23.3% of participants met the criteria for medication adherence. Variables significant at p < 0.05 in univariate analysis were entered into a multivariable logistic regression model. In the final model, older age of onset (adjusted OR = 0.789, 95% CI: 0.673-0.925, p = 0.003), good insight into illness (adjusted OR = 46.189, 95% CI: 5.364-397.755, p < 0.001), and positive family support (adjusted OR = 53.930, 95% CI: 4.757-611.385, p = 0.001) were independently associated with adherence; perceived stigma was not independently associated with adherence after adjustment (adjusted OR = 0.329, 95% CI: 0.066-1.634, p = 0.174). CONCLUSION: Medication adherence was low in this inpatient sample. Psychosocial factors, particularly illness insight and family support, were more strongly associated with adherence than clinical characteristics. These findings highlight the importance of integrating psychosocial interventions into bipolar disorder management strategies in Vietnam.