Shao Wen-Chuan, Chen Hung, Chang Ya-Fen, Lin Wei-Chen, Lin Esther Ching-Lan
Department of Nursing, National Cheng Kung University Hospital, Taiwan, ROC.
Hu Li Za Zhi. 2013 Oct;60(5):31-40. doi: 10.6224/JN.60.5.31.
Antipsychotics have been regarded as the most effective therapy for schizophrenia; however, Taiwan's non-adherence rate for prescribed antipsychotics of 50-80% is an important issue that relates directly and significantly to schizophrenia patient relapse rates.
This study examines the correlational and predictive relationships between medication adherence and rehospitalization in schizophrenia patients discharged from an acute ward.
This study used a prospective research design. Schizophrenia patients discharged from a psychiatric acute ward who stated their plan to live in the community were recruited as participants. Participant medication adherence was assessed via home visits during the 6-month follow-up period using scales including the Medication Adherence Questionnaire (MAQ), drug attitudes, and regimen knowledge. Rehospitalization data were retrieved from electronic medical records. Relationships between medication adherence and rehospitalization were analyzed using t-tests and regression analysis.
Seventy-seven patients with schizophrenia discharged from the acute ward were recruited in accordance with sampling criteria. The majority were male, young, unmarried, had poorer global function, had 12 years of education, and were not rehospitalized during the past 6-month period. Using binomial regression analysis, we found the relative risk for number of rehospitalizations during the 6-month period to be significantly less and the average scores for the total scale, attitude subscale, and knowledge subscale of medication adherence to have increased (0.194-0.79 times).
CONCLUSIONS/IMPLICATIONS FOR PRACTICE: Our findings support that better medication adherence in people with schizophrenia decreases rehospitalization risk. We urge clinicians to develop sensitive interventions to promote antipsychotics adherence in this population.
抗精神病药物一直被视为治疗精神分裂症最有效的疗法；然而，台湾地区抗精神病药物的规定服药依从率为50%-80%，这是一个直接且显著影响精神分裂症患者复发率的重要问题。
本研究探讨急性病房出院的精神分裂症患者药物依从性与再次住院之间的相关性和预测关系。
本研究采用前瞻性研究设计。招募从精神科急性病房出院且表示计划在社区生活的精神分裂症患者作为参与者。在6个月的随访期内，通过家访使用包括药物依从性问卷（MAQ）、药物态度和服药方案知识等量表评估参与者的药物依从性。从电子病历中检索再次住院数据。使用t检验和回归分析来分析药物依从性与再次住院之间的关系。
根据抽样标准，招募了77名从急性病房出院的精神分裂症患者。大多数为男性，年轻，未婚，整体功能较差，接受过12年教育，且在过去6个月内未再次住院。使用二项式回归分析，我们发现6个月内再次住院次数的相对风险显著降低，药物依从性总量表、态度子量表和知识子量表的平均得分有所提高（0.194 - 0.79倍）。
结论/实践意义：我们的研究结果支持精神分裂症患者更好的药物依从性可降低再次住院风险。我们敦促临床医生制定敏感的干预措施，以促进该人群对抗精神病药物的依从性。
