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基于短消息服务(SMS)的策略提高精神分裂症患者抗精神病药物的依从性。

A short message service (SMS)-based strategy for enhancing adherence to antipsychotic medication in schizophrenia.

机构信息

Department of Psychiatry, Hospital Universitario del Sureste, CIBERSAM, Madrid, Spain.

出版信息

Psychiatry Res. 2012 Dec 30;200(2-3):89-95. doi: 10.1016/j.psychres.2012.07.034. Epub 2012 Aug 17.

DOI:10.1016/j.psychres.2012.07.034
PMID:22901437
Abstract

BACKGROUND

The aim of this study was to assess the impact of a short message service (SMS)-based strategy on adherence to antipsychotic treatment.

METHODS

A multicentre, randomised, open-label, controlled, 6-month study with clinically stabilised outpatients with schizophrenia was conducted. The patients assigned to the intervention received daily SMS reminders to take their medication for 3 months. Self-reported medication adherence was determined using the Morisky Green Adherence Questionnaire (MAQ). Secondary outcomes were severity of illness, attitude towards medication, insight into illness and health-related quality of life.

RESULTS

A total of 254 patients were analysed. A significantly greater improvement in adherence was observed among patients receiving SMS text messages compared with the control group. The mean change in MAQ total score from baseline to month 3 was -1.0 (95% confidence interval (CI) -1.02, -0.98) and -0.7 (95%CI -0.72, -0.68), respectively (P=0.02). Greater improvement in negative, cognitive and global clinical symptoms at month 3 was observed. Attitude towards medication also significantly improved across the study in the intervention group versus the controls.

CONCLUSIONS

An SMS-based intervention seems feasible and acceptable for enhancing medication adherence. Further studies are needed to confirm whether this kind of intervention could be a complementary strategy to optimise adherence in schizophrenia.

摘要

背景

本研究旨在评估基于短信服务(SMS)的策略对精神分裂症患者抗精神病药物治疗依从性的影响。

方法

这是一项多中心、随机、开放标签、对照、为期 6 个月的研究,纳入了临床稳定的精神分裂症门诊患者。干预组患者每天会收到服药提醒的短信,持续 3 个月。采用 Morisky 绿色服药依从性问卷(MAQ)评估患者的自我报告服药依从性。次要结局为疾病严重程度、对药物的态度、对疾病的认识和健康相关生活质量。

结果

共分析了 254 例患者。与对照组相比,接受短信提醒的患者在服药依从性方面有显著改善。从基线到第 3 个月 MAQ 总分的平均变化分别为-1.0(95%置信区间[CI] -1.02,-0.98)和-0.7(95%CI -0.72,-0.68)(P=0.02)。第 3 个月时,阴性、认知和总体临床症状的改善更为显著。干预组患者对药物的态度在整个研究过程中也显著改善。

结论

基于 SMS 的干预措施似乎是可行且可接受的,可以提高患者的服药依从性。需要进一步的研究来证实这种干预是否可以成为优化精神分裂症患者服药依从性的一种补充策略。

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