Byrne Mitchell K, Deane Frank P, Lambert Gordon, Coombs Tim
Department of Psychology, University of Wollongong, Wollongong, Nsw 2522, Australia.
Aust N Z J Psychiatry. 2004 Apr;38(4):246-53. doi: 10.1080/j.1440-1614.2004.01344.x.
Patient nonadherence to psychiatric medication is a key cause of relapse but clinicians do not appear to possess specific adherence skills. We sought to demonstrate that a brief training program on medication adherence strategies could improve the adherence skills, attitudes and knowledge of mental health clinicians.
Twenty-three Tasmanian mental health workers were provided a 3 day training workshop on strategies to enhance patient adherence to medications (Medication Alliance). Pre- and post-training measures were taken of clinician knowledge about adherence strategies, ability to identify predictors of nonadherence, attitudes toward working with nonadherent patients, and optimism about treatment outcomes for patients. Videotapes of clinicians demonstrating key adherence therapy skills were also collected before and after training and blind-rated by two experienced therapists.
A series of paired samples t-tests indicated significant improvements in skills, knowledge and attitudes.
Compared with similar studies in the UK, Medication Alliance was found to be an effective and efficient training program. However, there is a need for further research to assess maintenance of training effects over time and patient outcomes.
患者不坚持服用精神科药物是病情复发的一个关键原因，但临床医生似乎并不具备特定的坚持服药技能。我们试图证明，一个关于药物治疗依从性策略的简短培训项目可以提高心理健康临床医生的依从性技能、态度和知识水平。
为23名塔斯马尼亚心理健康工作者提供了一个为期3天的关于提高患者药物治疗依从性策略的培训工作坊（药物联盟）。在培训前后分别对临床医生关于依从性策略的知识、识别不依从预测因素的能力、对与不依从患者合作的态度以及对患者治疗结果的乐观程度进行了测量。还在培训前后收集了临床医生展示关键依从性治疗技能的录像带，并由两名经验丰富的治疗师进行盲评。
一系列配对样本t检验表明，在技能、知识和态度方面有显著改善。
与英国的类似研究相比，发现药物联盟是一个有效且高效的培训项目。然而，需要进一步研究以评估培训效果随时间的维持情况以及患者的治疗结果。
