¹Faculty of Medicine Universitas Brawijaya, Department of Psychiatry, Malang, Indonesia, ²Universitas Brawijaya Hospital, Department of Psychiatry, Malang, Indonesia, ³Saiful Anwar General Hospital, Psychiatry, Malang, Indonesia

Background: Medication adherence is a key determinant of successful treatment outcomes among individuals with bipolar disorder. In Indonesia, community-based hospitals typically provide medication coverage of 60,000–150,000 IDR (3.60–9 USD) per visit, which includes standard formulary medications and fee for physician services. Non-adherence may lead to relapse, rehospitalization, and reduced quality of life. A comprehensive assessment model combined with neuroscience-based psychoeducation has emerged as an alternative approach that is more scientific, less stigmatizing, and more acceptable to patients. This model may enhance the effectiveness of psychopharmacological treatment despite limited medication coverage.

Aims & Objectives: 

1. To evaluate the effectiveness of comprehensive assessment and neuroscience-based psychoeducation on treatment adherence among patients with bipolar disorder attending the Psychiatry Outpatient Clinic of Universitas Brawijaya Hospital, Indonesia, over one year.
2. To examine the patterns of medication combinations that can be covered for bipolar patients at Universitas Brawijaya Hospital, Indonesia.

Method: A retrospective descriptive study using consecutive sampling was conducted on all bipolar patients who visited between April 2024 and March 2025. During the first visit, all patients underwent a comprehensive assessment and received neuroscience-based psychoeducation integrating diagnostic explanation, neurobiological mechanisms, and therapeutic rationale, followed by prescription of psychopharmacological treatment. Adherence was measured by patients returning to the outpatient clinic more than once, based on hospital medical record data. Medication combination types were documented.

Results: A total of 167 individuals with bipolar disorder were identified, with 51.5% returning for more than one visit. Visit distribution was as follows:

• 1 visit: 47.9%
• 2–5 visits: ~41%
• ≥ 6 visits: ~11%

The interval between sessions ranged from 2–4 weeks.
Medication combinations affordable within 3.60–9 USD included:

• risperidone + divalproex
• olanzapine + divalproex
• lamotrigine monotherapy
• quetiapine monotherapy
• SSRI combined with an antipsychotic
  These could be supplemented with benzodiazepines such as lorazepam or clobazam.

Discussion & Conclusions: Comprehensive assessment and neuroscience-based psychoeducation demonstrated improved adherence compared to national findings, which show that most psychiatric patients discontinue treatment within the first 1–2 months. These results align with international studies reporting that neuroscience-informed psychoeducation enhances treatment engagement, illness understanding, and positive perceptions toward psychiatric interventions. Thus, even with limited insurance coverage, this approach can foster good adherence among patients.