Neuropsychiatric Hospital, Aro, Abeokuta, Ogun State, Nigeria.
Gen Hosp Psychiatry. 2012 Jan-Feb;34(1):72-9. doi: 10.1016/j.genhosppsych.2011.09.001. Epub 2011 Oct 28.
The aim of this study was to examine medication adherence among outpatients with schizophrenia in relation to their subjective quality of life and other sociodemographic, clinical and service related factors.
Three hundred and thirteen consecutive outpatient clinic attendees with a Diagnostic and Statistical Manual of Mental Disorders Fourth Edition (DSM-IV) diagnosis of schizophrenia confirmed with the Structured Clinical Interview for Diagnosis were recruited for the study. Respondents were interviewed using a questionnaire evaluating sociodemographic, medication, illness and clinic attendance related variables. Medication adherence was assessed using the Morisky medication adherence questionnaire. Participants also completed the World Health Organization Quality of Life Scale-BREF questionnaire as a measure of their subjective quality of life, while severity of illness was measured using the Brief Psychiatric Rating Scale (BPRS).
Overall, 40.3% of the respondents were medication nonadherent. Medication adherent respondents significantly reported their perceived social support as "good" (P=.006), took significantly fewer number of medications (P≤.001), had higher medication use recall scores (P≤.001), had lower total BPRS scores (P=.001) and were "very satisfied" with their outpatient care (P=.002). Independent predictors of medication nonadherence were BPRS score [odds ratio (OR)=1.08, 95% confidence interval (95% CI)=1.03-1.13], outpatient clinic default (OR= 4.97, 95% CI=2.59-9.53) and moderate satisfaction with outpatient care (OR=2.78, 95% CI=1.47-5.24). Medication nonadherence was significantly associated with lower scores on all domains and facets of quality of life.
Medication nonadherence is common among outpatients with schizophrenia and is associated with poor quality of life. Clinicians' awareness of the risk factors for medication nonadherence early in patients' management may significantly improve treatment outcomes, including patients' quality of life.
本研究旨在探讨精神分裂症门诊患者的药物依从性与其主观生活质量及其他社会人口学、临床和服务相关因素之间的关系。
本研究纳入了 313 名连续的精神分裂症门诊就诊者，他们均符合《精神障碍诊断与统计手册》第四版（DSM-IV）的诊断标准，并通过结构临床访谈进行了确诊。研究对象通过问卷评估了社会人口学、药物使用、疾病和就诊相关变量。采用 Morisky 药物依从性问卷评估药物依从性。参与者还完成了世界卫生组织生活质量量表简表（WHOQOL-BREF），以评估他们的主观生活质量，同时采用简明精神病评定量表（BPRS）评估疾病严重程度。
总体而言，有 40.3%的受访者存在药物不依从。药物依从性良好的受访者显著报告其感知社会支持为“良好”（P=.006），服用的药物种类明显更少（P≤.001），药物使用记忆评分更高（P≤.001），BPRS 总分更低（P=.001），对门诊护理非常满意（P=.002）。药物不依从的独立预测因素包括 BPRS 评分[比值比（OR）=1.08，95%置信区间（95%CI）=1.03-1.13]、门诊失约（OR=4.97，95%CI=2.59-9.53）和对门诊护理的中等满意度（OR=2.78，95%CI=1.47-5.24）。药物不依从与生活质量所有领域和方面的评分均显著降低相关。
精神分裂症门诊患者中药物不依从较为常见，与生活质量较差相关。临床医生在患者管理早期就意识到药物不依从的风险因素，可能会显著改善治疗结果，包括患者的生活质量。
