Kelly G R, Scott J E, Mamon J
Department of Veterans Affairs Medical Center, Perry Point, MD.
Med Care. 1990 Dec;28(12):1181-97. doi: 10.1097/00005650-199012000-00006.
Medication noncompliance occurs among as many as one-third to one-half of all medical and psychiatric outpatients. Noncompliance has serious consequences for individuals diagnosed with schizophrenia, often resulting in higher rates of relapse and rehospitalization, and poorer community adjustment. Health education interventions have been shown to be effective in promoting compliance among patients with chronic medical illness such as hypertension or diabetes, but there have been few randomized trials of this approach among patients with chronic psychiatric disorders. This paper presents the results of an application of health education among a group of male psychiatric outpatients. Two interventions were developed which used health education techniques to 1) engage families or significant others as active participants in the aftercare process, and 2) train patients to become effective health care consumers. A total of 418 individuals participated in a six-month trial over a four-year study. Both interventions significantly improved medication compliance among those who received them. The results show that comparatively brief interventions can significantly alter medication compliance behavior and improve the quality of life for patients with chronic psychiatric disorders.
在所有内科和精神科门诊患者中,多达三分之一到二分之一的人存在用药依从性差的问题。对于被诊断为精神分裂症的个体而言,用药依从性差会产生严重后果,常常导致更高的复发率和再住院率,以及更差的社区适应情况。健康教育干预已被证明在促进患有慢性内科疾病(如高血压或糖尿病)的患者的依从性方面是有效的,但针对患有慢性精神疾病的患者进行这种方法的随机试验却很少。本文介绍了在一组男性精神科门诊患者中应用健康教育的结果。开发了两种干预措施,它们利用健康教育技术来:1)让家庭或重要他人成为后续护理过程中的积极参与者;2)培训患者成为有效的医疗保健消费者。在一项为期四年的研究中,共有418人参与了为期六个月的试验。两种干预措施都显著提高了接受干预者的用药依从性。结果表明,相对简短的干预措施可以显著改变用药依从性行为,并改善患有慢性精神疾病患者的生活质量。