Department of Psychiatry, Hospital Meixoeiro, Complejo Hospitalario Universitario de Vigo, Vigo, Spain.
Neuropsychiatr Dis Treat. 2013;9:1163-70. doi: 10.2147/NDT.S49080. Epub 2013 Aug 12.
Nonadherence is a well-known problem among schizophrenia patients, among whom relapse is fivefold more likely, adversely affecting health, employment, and social functioning. The Spanish Adherencia Terapéutica en la Esquizofrenia (ADHES) survey was developed to determine the scope and causes of medication nonadherence in schizophrenia.
The 20-question ADHES survey was distributed to 19,370 psychiatrists in 13 Asia-Pacific countries in January-April 2012, to ascertain psychiatrists' perceptions of antipsychotic medication adherence levels among their schizophrenia patients, reasons for partial/nonadherence, their preferred methods of assessing adherence, and strategies to improve adherence. Responses are reported as mean and range across countries.
Four thousand, six hundred sixty one psychiatrists (24% of recipients) completed the survey (highest contributors: People's Republic of China, 1854; India, 1616). Psychiatrists perceived that 56% (range, 30%-71%) of schizophrenia patients were non- or partially adherent to medication. Patients discontinue medication primarily due to lack of insight into their condition (mean, 37%; 1%-65%) and because patients consider medication unnecessary when feeling better (mean, 27%; 15%-68%). Over half of psychiatrists (mean, 55%; 42%-99%) assess medication adherence at every visit, almost exclusively (81%) by asking their patients, versus quantitative measures. One in three psychiatrists expressed their preference to switch to or add a long-acting antipsychotic to improve adherence (15%-82%).
The substantial prevalence of partial/nonadherence to medication demonstrates that more proactive management of patients with schizophrenia is needed to improve adherence and thereby treatment outcomes.
Registration of this study was not required.
精神分裂症患者普遍存在不依从治疗的问题，其复发风险增加五倍，从而对健康、就业和社会功能产生不利影响。西班牙的《精神分裂症治疗依从性调查》（ADHES）旨在确定精神分裂症患者药物不依从的范围和原因。
2012 年 1 月至 4 月，该 20 个问题的 ADHES 调查在亚太地区的 13 个国家向 19370 名精神科医生发放，以了解精神科医生对其精神分裂症患者抗精神病药物依从性水平的看法、部分/不依从的原因、他们首选的评估依从性的方法以及提高依从性的策略。结果以国家间的平均值和范围报告。
4661 名精神科医生（收件人的 24%）完成了调查（最多的贡献者：中华人民共和国，1854；印度，1616）。精神科医生认为 56%（范围，30%-71%）的精神分裂症患者不依从或部分依从药物治疗。患者停止用药主要是因为缺乏对自身病情的了解（平均 37%；1%-65%），以及当感觉好转时认为药物不必要（平均 27%；15%-68%）。超过一半的精神科医生（平均 55%；42%-99%）每次就诊时评估药物依从性，几乎完全（81%）通过询问患者，而不是使用定量措施。三分之一的精神科医生表示更倾向于改用或添加长效抗精神病药物来提高依从性（15%-82%）。
部分/不依从药物治疗的比例很高，这表明需要更积极地管理精神分裂症患者，以提高依从性，从而改善治疗效果。
本研究未要求注册。
