Razali S M, Yusoff M Z A M
Discipline of Psychological and Behavioural Medicine, Faculty of Medicine, Universiti Teknologi Mara, Sungai Buloh Campus, 47000 Sungai Buloh, Selangor, Malaysia.
Department of Psychiatry General Hospital Kota Bharu, 15200 Kota Bharu, Kelantan, Malaysia.
East Asian Arch Psychiatry. 2014 Jun;24(2):68-74.
Adherence to medication is essential for maximising the outcomes of patients with schizophrenia as the consequences of poor adherence are devastating. The study aimed to compare medication adherence between patients with relapse schizophrenia and those attending psychiatric follow-up clinics, and to determine the factors affecting adherence.
This was a cross-sectional study involving 70 patients with schizophrenia who were divided equally into 2 groups. Medication adherence was assessed with the Medication Adherence Rating Scale. Appropriate instruments were used to measure insight, social support, and psychopathology. Various socio-demographic and clinical variables were explored to find associations with medication adherence.
Medication adherence among patients with schizophrenia was poor; 51% of the patients did not adhere to a medication regimen. Adherence was better in outpatients with schizophrenia (61%) than in relapse cases (39%), although the difference was not statistically significant (t = 1.70; p = 0.09). Besides, relapse patients had significant higher number of admission (X(2) = 22.95; p < 0.05) and severe psychopathology (t = -29.96; p < 0.05), while perceived social support was significantly better in outpatients with schizophrenia (t = 2.90; p < 0.05). Frequency of admission (adjusted b = -0.55; 95% confidence interval [CI], -0.99 to -0.10; p < 0.05) and psychopathology (adjusted b = -0.12; 95% CI, -0.24 to -0.01; p < 0.05) were also significantly associated with medication adherence.
Medication adherence among both groups of patients with schizophrenia was poor. If adherence is addressed appropriately, the number of admissions and severity of psychopathology could be improved.
坚持服药对于使精神分裂症患者获得最佳治疗效果至关重要,因为服药依从性差的后果是灾难性的。本研究旨在比较复发型精神分裂症患者与精神科随访门诊患者的服药依从性,并确定影响依从性的因素。
这是一项横断面研究,涉及70例精神分裂症患者,平均分为两组。采用药物依从性评定量表评估服药依从性。使用适当的工具测量自知力、社会支持和精神病理学。探索各种社会人口学和临床变量,以发现与服药依从性的关联。
精神分裂症患者的服药依从性较差;51%的患者未坚持药物治疗方案。精神分裂症门诊患者的依从性(61%)优于复发患者(39%),尽管差异无统计学意义(t = 1.70;p = 0.09)。此外,复发患者的住院次数显著更多(X(2) = 22.95;p < 0.05)且精神病理学症状更严重(t = -29.96;p < 0.05),而精神分裂症门诊患者感知到的社会支持显著更好(t = 2.90;p < 0.05)。住院次数(调整后b = -0.55;95%置信区间[CI],-0.99至-0.10;p < 0.05)和精神病理学(调整后b = -0.12;95%CI,-0.24至-0.01;p < 0.05)也与服药依从性显著相关。
两组精神分裂症患者的服药依从性均较差。如果适当地解决依从性问题,住院次数和精神病理学症状的严重程度可能会得到改善。