From the Department of Psychiatry and Behavioral Sciences, David Geffen School of Medicine; VA Desert Pacific Mental Illness Research, Education, and Clinical Center; and the Semel Institute, University of California, Los Angeles.
J Clin Psychiatry. 2013 Oct;74(10):e21. doi: 10.4088/JCP.12117tx2c.
The majority of patients with schizophrenia will be nonadherent at some point during their treatment, which is why clinicians must assess adherence at each visit and promptly address any barriers. Treatment adherence can be negatively impacted by substance use, cognitive impairment, complex treatment regimens, and antipsychotic-induced adverse effects. Clinicians must monitor these risk factors, particularly metabolic, neurologic, and other side effects, not only to improve adherence but also to protect patients from dangerous health conditions. Interventions that can address some barriers to treatment adherence include adjusting medications as necessary, implementing lifestyle changes, using long-acting injectable antipsychotics, educating patients and their families, and implementing psychosocial therapy. With the appropriate interventions and support, patients with schizophrenia can maintain their treatment regimens and avoid relapse.
大多数精神分裂症患者在治疗过程中的某个阶段会不依从,这就是为什么临床医生必须在每次就诊时评估依从性,并及时解决任何障碍。药物使用、认知障碍、复杂的治疗方案和抗精神病药物引起的不良反应都会对治疗依从性产生负面影响。临床医生必须监测这些危险因素,特别是代谢、神经和其他副作用,不仅要提高依从性,还要保护患者免受危险的健康状况的影响。可以解决一些治疗依从性障碍的干预措施包括根据需要调整药物、实施生活方式改变、使用长效注射抗精神病药物、教育患者及其家属以及实施心理社会治疗。通过适当的干预措施和支持,精神分裂症患者可以维持其治疗方案并避免复发。