Rettenbacher Maria A, Hofer Alex, Eder Ursula, Hummer Martina, Kemmler Georg, Weiss Elisabeth M, Fleischhacker Wolfgang W
Department of Biological Psychiatry, Innsbruck University Clinics, Innsbruck, Austria.
J Clin Psychiatry. 2004 Sep;65(9):1211-8. doi: 10.4088/jcp.v65n0908.
In a cross-sectional study, we investigated the influence of several factors on compliance in schizophrenia outpatients, including patients' attitudes toward the illness and medication, specifically antipsychotic medication; adverse effects; and attitudes of caregivers and relatives toward the illness and medication.
Patients suffering from schizophrenia (ICD-10 diagnosis) of at least 1-year's duration whose discharge from an inpatient ward was at least 6 weeks prior to inclusion in the study were investigated. Study instruments included a semi-structured compliance interview, the Positive and Negative Syndrome Scale, the Udvalg for Klinske Undersogelser Side Effect Rating Scale, the St. Hans Rating Scale, and the Hillside Akathisia Scale. Data were collected from May 1998 to December 2001.
52.5% (N = 32) of the 61 investigated patients were fully compliant, 39.3% (N = 24) were partially compliant, and only 8.2% (N = 5) were noncompliant. We found positive correlations between compliance and the patients' feelings of a positive effect of the drug on the illness, between compliance and negative symptoms, and between compliance and antipsychotic-induced psychological side effects.
Our findings reemphasize the importance of taking subjective attitudes and concerns of patients with respect to their illness and medication seriously. Therefore, it is indispensable to include patients and, if possible, their relatives in the treatment decision process to enhance medication compliance in schizophrenia patients.
在一项横断面研究中,我们调查了几个因素对精神分裂症门诊患者依从性的影响,这些因素包括患者对疾病和药物(特别是抗精神病药物)的态度、不良反应,以及照顾者和亲属对疾病和药物的态度。
对患有精神分裂症(国际疾病分类第十版诊断)且病程至少1年、在纳入研究前至少6周已从住院病房出院的患者进行调查。研究工具包括半结构化依从性访谈、阳性和阴性症状量表、乌氏临床副作用评定量表、圣汉斯评定量表和山坡静坐不能量表。数据收集时间为1998年5月至2001年12月。
在61名被调查患者中,52.5%(N = 32)完全依从,39.3%(N = 24)部分依从,只有8.2%(N = 5)不依从。我们发现依从性与患者对药物对疾病的积极作用的感受之间、依从性与阴性症状之间以及依从性与抗精神病药物引起的心理副作用之间存在正相关。
我们的研究结果再次强调了认真对待患者对其疾病和药物的主观态度及担忧的重要性。因此,将患者及其亲属纳入治疗决策过程对于提高精神分裂症患者的药物依从性是必不可少的。