Centre for Behavioural Medicine, UCL School of Pharmacy, London, UK.
Curr Opin Psychiatry. 2013 Sep;26(5):446-52. doi: 10.1097/YCO.0b013e3283642da4.
Nonadherence to appropriately prescribed medication for psychiatric disorders prevents patients from realizing the full benefits of their treatment and negatively impacts on individuals, their families and the healthcare system. Understanding and reducing nonadherence is therefore a key challenge to quality care for patients with psychiatric disorders. This review highlights findings regarding the prevalence and consequence of nonadherence, barriers to adherence and new intervention methods from 2012 onwards.
Recent research has highlighted that nonadherence is a global challenge for psychiatry and has linked nonadherence to poorer outcomes, including hospital admissions, suicide and mortality. Optimizing medication regimens can reduce nonadherence; however, often a complex interplay of factors affects individuals' motivation and ability to follow their prescription. Psychiatrists can enable patients to develop an accurate model of their illness and treatment and facilitate adherence. However, nonadherence is often a hidden issue within consultations. Novel interventions using new technologies and tailoring techniques may have the potential to reduce nonadherence.
Nonadherence remains a significant challenge for patients with psychiatric disorders, physicians and healthcare systems. New developments demonstrate the importance of developing tailored interventions to enable patients to overcome perceptual and practical barriers to adherence.
精神障碍患者未遵医嘱服用适当的药物，导致其无法充分受益于治疗，对个人、家庭和医疗保健系统产生负面影响。因此，了解和减少不依从性是为精神障碍患者提供优质护理的关键挑战。本篇综述重点介绍了 2012 年以来关于不依从性的流行率和后果、不依从性的障碍以及新干预方法的研究结果。
最近的研究强调了不依从性是精神科的全球性挑战，并将不依从性与较差的结局（包括住院、自杀和死亡）联系起来。优化药物治疗方案可以减少不依从性；然而，通常情况下，多种因素的复杂相互作用会影响个人遵循处方的动机和能力。精神科医生可以帮助患者准确了解自己的疾病和治疗情况，并促进其依从性。然而，不依从性往往是咨询中的一个隐藏问题。使用新技术和定制技术的新干预措施有可能减少不依从性。
精神障碍患者、医生和医疗保健系统仍然面临着不依从性的重大挑战。新的发展表明，开发针对患者的干预措施非常重要，以帮助他们克服对依从性的认知和实际障碍。
