Byerly Matthew J, Thompson Ann, Carmody Thomas, Bugno Rhiannon, Erwin Thomas, Kashner Michael, Rush A John
Department of Psychiatry, University of Texas Southwestern Medical Center 6363 Forest Park Rd., Suite 651, Dallas, TX 75235-8828, USA.
Psychiatr Serv. 2007 Jun;58(6):844-7. doi: 10.1176/ps.2007.58.6.844.
This study evaluated the validity of prescriber, patient, and research assistant ratings of adherence to prescribed oral antipsychotic medication among outpatients with schizophrenia or schizoaffective disorder in comparison with electronic monitoring.
Adult outpatients with schizophrenia (N=35) or schizoaffective disorder (N=26) received adherence assessments via electronically monitored medication vial caps as well as by monthly prescriber, patient, and research assistant report for up to six months.
Electronic monitoring detected greater nonadherence rates (57%) than either prescribers (7%) or patients (5%), though the research assistant ratings were 54%. No directional bias was found between electronic monitoring and assignment of adherence by research assistants, although disagreement occurred in 36% of cases.
Both patients and prescribers grossly overestimated medication adherence, which may interfere with or reduce the effectiveness of diligent medication management.
本研究评估了精神分裂症或分裂情感性障碍门诊患者中，处方医生、患者及研究助理对口服抗精神病药物依从性评分的有效性，并与电子监测结果进行比较。
35例精神分裂症成年门诊患者及26例分裂情感性障碍成年门诊患者接受了长达6个月的依从性评估，评估方式包括通过电子监测药瓶瓶盖以及每月由处方医生、患者和研究助理报告。
电子监测发现的非依从率（57%）高于处方医生（7%）或患者（5%）报告的结果，不过研究助理报告的评分是54%。电子监测与研究助理对依从性的判定之间未发现方向性偏差，尽管在36%的病例中存在分歧。
患者和处方医生都严重高估了药物依从性，这可能会干扰或降低药物规范管理的效果。
