识别有抗抑郁药治疗依从性风险的初级保健患者。
Identification of primary care patients at risk of nonadherence to antidepressant treatment.
作者信息
Akerblad Ann-Charlotte, Bengtsson Finn, Holgersson Margareta, von Knorring Lars, Ekselius Lisa
机构信息
Department of Neuroscience, Psychiatry, Uppsala University Hospital, Uppsala University, Uppsala, Sweden;
出版信息
Patient Prefer Adherence. 2008 Feb 2;2:379-86. doi: 10.2147/ppa.s3511.
INTRODUCTION
Poor adherence to antidepressant treatment is common, and results in increased disability and costs. Several factors are thought to influence patients' ability and willingness to adhere. So far, however, consensus is lacking regarding patient characteristics that predict nonadherence. The purpose of this study was to identify predictors of nonadherence to antidepressant treatment that can be ascertained at treatment start.
METHOD
The present study used data from a randomized controlled trial with the main objective of studying the effect of two different compliance-enhancing programs on treatment adherence and treatment response in 1031 primary care patients with major depression. In this study, logistic regression analyses were performed to examine patient- and illness-related characteristics potentially associated with nonadherence.
RESULTS
Nonadherence to antidepressant treatment was predicted by age under 35 or over 64 years, presence of personality disorder, sensation-seeking personality traits, substance abuse, and absence of concomitant medications.
CONCLUSION
Certain patient- and illness-related characteristics may imply an increased risk of nonadherence to antidepressant treatment. Giving special attention to subjects with such characteristics may improve adherence.
引言
抗抑郁治疗的依从性差很常见，会导致残疾增加和成本上升。有几个因素被认为会影响患者坚持治疗的能力和意愿。然而，到目前为止，对于预测不依从的患者特征尚未达成共识。本研究的目的是确定在治疗开始时就能确定的抗抑郁治疗不依从的预测因素。
方法
本研究使用了一项随机对照试验的数据，其主要目的是研究两种不同的依从性增强方案对1031名患有重度抑郁症的初级保健患者的治疗依从性和治疗反应的影响。在本研究中，进行了逻辑回归分析，以检查可能与不依从相关的患者和疾病相关特征。
结果
35岁以下或64岁以上的年龄、人格障碍的存在、寻求刺激的人格特质、药物滥用以及没有同时服用其他药物可预测抗抑郁治疗的不依从。
结论
某些患者和疾病相关特征可能意味着抗抑郁治疗不依从的风险增加。特别关注具有此类特征的患者可能会提高依从性。
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