The Center for the Assessment of Pharmaceutical Practices (CAPP), Boston University School of Public Health, Boston, MA, USA.
Neuropsychiatr Dis Treat. 2009;5:491-8. doi: 10.2147/ndt.s6637. Epub 2009 Oct 12.
The importance of medication adherence in sustaining control of schizophrenic symptoms has generated a great deal of interest in comparing levels of treatment adherence with different antipsychotic agents. However, the bulk of the research has yielded results that are often inconsistent. In this prospective, observational study, we assessed the measurement properties of 3 commonly used, pharmacy-based measures of treatment adherence with antipsychotic agents in schizophrenia using data from the Veterans Health Administration during 2000 to 2005. Patients were selected if they were on antipsychotics and diagnosed with schizophrenia (N = 18,425). A gap of >/=30 days (with no filled index medication) was used to define discontinuation of treatment as well as medication "episodes," or the number of times a patient returned to the same index agent after discontinuation of treatment within a 1-year period. The study found that the 3 existing measures differed in their approaches in measuring treatment adherence, suggesting that studies using these different measures would generate different levels of treatment adherence across antipsychotic agents. Considering the measurement problems associated with each existing approach, we offered a new, medication episode-specific approach, which would provide a fairer comparison of the levels of treatment adherence across different antipsychotic agents.
药物依从性对维持精神分裂症症状控制的重要性，使得人们对不同抗精神病药物的治疗依从性水平进行比较产生了浓厚的兴趣。然而，大量的研究结果往往不一致。在这项前瞻性、观察性研究中，我们利用 2000 年至 2005 年退伍军人健康管理局的数据，评估了 3 种常用于评估抗精神病药物治疗依从性的基于药房的测量方法在精神分裂症中的测量特性。入选的患者需要正在服用抗精神病药物并被诊断为精神分裂症（N=18425）。如果患者停药时间超过 30 天（没有服用索引药物），或者在 1 年内停药后再次使用同一索引药物的次数超过规定次数，则定义为治疗中断和药物“发作”。研究发现，现有的 3 种测量方法在测量治疗依从性的方法上存在差异，这表明使用这些不同测量方法的研究将在不同的抗精神病药物之间产生不同的治疗依从性水平。考虑到每种现有方法都存在测量问题，我们提出了一种新的、针对药物发作的特定方法，这将为不同抗精神病药物之间的治疗依从性水平提供更公平的比较。
