Department of Psychiatry, Hospital del Sureste, Arganda del Rey, Madrid, Spain.
Int J Psychiatry Clin Pract. 2010 Nov;14(4):274-81. doi: 10.3109/13651501.2010.505343. Epub 2010 Sep 14.
Abstract Objective. Adherence to prescribed antipsychotic medication is a major factor in achieving optimal long-term clinical outcomes. The aim of this study was to evaluate the impact of a telephone-based strategy provided by a nurse on adherence to antipsychotic treatment among patients with schizophrenia. Methods. A total of 928 clinically stable outpatients with schizophrenia were randomized to receive a monthly telephone call by a nurse or routine clinical care. Telephone calls were performed at weeks 4, 8, and 12, consisting of a standardized interview to detect and assess therapeutic adherence and subjective attitude towards medication. Patients were followed for 4 months. A cut-point of ≥ 60% of prescribed dose was used to classify patients as being adherent. Results. At week 16, a significantly higher percentage of patients who received a telephone-based follow-up (96.7%, n = 410) were classified as adherent compared to the control group (91.2%, n = 402) (P = 0.0007). Patients in the intervention group were significantly more likely to be adherent than control group (adjusted OR = 3.3 95% CI 1.6-6.6, P = 0.0001). Conclusions. Telephone-based nursing strategy showed a significant improvement in adherence to antipsychotic drugs. Further studies are necessary to confirm if this kind of intervention could be a complementary strategy to optimize adherence in patients with schizophrenia.
摘要 目的。遵循规定的抗精神病药物是实现最佳长期临床结局的主要因素。本研究旨在评估由护士提供的基于电话的策略对精神分裂症患者抗精神病治疗依从性的影响。
方法。共纳入 928 例临床稳定的精神分裂症门诊患者，随机分为接受护士每月电话随访组或常规临床护理组。在第 4、8 和 12 周进行电话随访，包括进行标准化访谈以检测和评估治疗依从性以及对药物的主观态度。患者随访 4 个月。将规定剂量的 ≥ 60%作为分类标准，以确定患者是否依从。
结果。在第 16 周，接受基于电话的随访的患者中，有更高比例（96.7%，n=410）被归类为依从，而对照组（91.2%，n=402）（P=0.0007）。干预组患者的依从性明显高于对照组（调整后的 OR=3.3，95%CI 1.6-6.6，P=0.0001）。
结论。基于电话的护理策略显著提高了抗精神病药物的依从性。需要进一步研究来证实这种干预是否可以成为优化精神分裂症患者依从性的补充策略。
