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精神分裂症患者的坚定扩展现患：一项准实验对照试验的结果。

Clinical and functional outcome of assertive outreach for patients with schizophrenic disorder: Results of a quasi-experimental controlled trial.

机构信息

Competence Tandem Integrated Care, Innovation Incubator, Leuphana University Lüneburg, Lüneburg, Germany; Department of Psychosomatic Medicine and Psychotherapy, University Medical Centre Hamburg-Eppendorf and Schön Clinic Hamburg Eilbek,, Hamburg, Germany.

Competence Tandem Integrated Care, Innovation Incubator, Leuphana University Lüneburg, Lüneburg, Germany.

出版信息

Eur Psychiatry. 2015 Sep;30(6):736-42. doi: 10.1016/j.eurpsy.2015.04.003. Epub 2015 May 21.

DOI:10.1016/j.eurpsy.2015.04.003

PMID:26003931

Abstract

BACKGROUND

The majority of studies support modern assertive health service models. However, the evidence is limited for parts of continental Europe, as well as for the pharmacological adherence outcome parameter.

METHOD

We conducted a quasi-experimental controlled trial including adult patients with a schizophreniform disorder and a maximum of 60 points on the Global Assessment of Functioning Scale (GAF). Interventions (n=176) and controls (TAU, n=142) were assessed every six-month within one year in 17 study practices in rural areas. Mental and functional state were rated using the Brief Psychiatric Rating Scale (BPRS) and the GAF. Functional limitations and pharmacological adherence were patient-rated using the WHO-Disability Assessment Schedule II (WHODAS-II) and the Medication Adherence Report Scale (MARS). We computed multilevel mixed models.

RESULTS

The GAF and BPRS of both groups improved significantly, yet the increase in the intervention group was significantly higher. In contrast, patient-rated variables - WHODAS-II and MARS - neither showed a stable temporal improvement nor a difference between groups.

CONCLUSION

Our findings only partly support the investigated AO intervention, because of conflicting results between clinician- and patient-ratings. Accordingly, the benefits of AO need to be further evaluated.

摘要

背景

大多数研究都支持现代积极的卫生服务模式。然而，部分欧洲大陆国家以及药物治疗依从性这一结果参数的证据有限。

方法

我们开展了一项准实验性对照试验，纳入了患有精神分裂样障碍且总体功能量表（GAF）评分最高为 60 分的成年患者。在为期一年的时间里，17 个农村地区的研究实践中，干预组（n=176）和对照组（TAU，n=142）每六个月评估一次。使用简明精神病评定量表（BPRS）和总体功能量表（GAF）评估精神和功能状态。使用世界卫生组织残疾评定量表 II（WHODAS-II）和药物依从性报告量表（MARS）评估功能障碍和药物治疗依从性。我们计算了多层次混合模型。