Chien Wai Tong, Mui Jolene, Gray Richard, Cheung Eric
School of Nursing, Faculty of Health and Social Sciences, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong, S.A.R., China.
Castle Peak Hospital, Tuen Mun, New Territories, Hong Kong, S.A.R., China.
BMC Psychiatry. 2016 Feb 25;16:42. doi: 10.1186/s12888-016-0744-6.
Current practice guidelines for schizophrenia care recommend that antipsychotic medication is essential for patients' long-term maintenance treatment but their non-adherence to this medication is still a main obstacle to relapse prevention. This study evaluated the effects of a motivational-interviewing-based adherence therapy for people with schizophrenia spectrum disorders.
This randomised controlled trial was conducted with 134 outpatients with schizophrenia spectrum disorders; 67 of them received a six-session adherence therapy (in addition to usual care) and 67 received usual psychiatric care alone. Participants' outcome measures included symptom severity, medication adherence, hospitalisation rates, insight into illness/treatment, and functioning.
The adherence therapy group reported significantly greater improvements in symptom severity (p < 0.003), insight into illness/treatment (p < 0.001), functioning (p < 0.005), duration of re-hospitalisations (p < 0.005), and medication adherence (p < 0.005) over 18 months follow-up, when compared with usual care alone.
Motivational-interviewing-based adherence therapy can be an effective approach to treatment for people with early stage of schizophrenia who poorly adhere to medication regimen.
ClinicalTrials.gov NCT01780116, registration date January 29, 2013.
目前精神分裂症治疗的实践指南推荐，抗精神病药物对患者的长期维持治疗至关重要，但患者对该药物的不依从性仍是预防复发的主要障碍。本研究评估了基于动机性访谈的依从性治疗对精神分裂症谱系障碍患者的效果。
对134例精神分裂症谱系障碍门诊患者进行了这项随机对照试验；其中67例接受了为期六次的依从性治疗（除常规治疗外），67例仅接受常规精神科治疗。参与者的结局指标包括症状严重程度、药物依从性、住院率、对疾病/治疗的洞察力及功能状况。
与仅接受常规治疗相比，在18个月的随访中，依从性治疗组在症状严重程度（p < 0.003）、对疾病/治疗的洞察力（p < 0.001）、功能状况（p < 0.005）、再次住院时长（p < 0.005）及药物依从性（p < 0.005）方面均有显著改善。
基于动机性访谈的依从性治疗对于药物治疗依从性差的早期精神分裂症患者可能是一种有效的治疗方法。
ClinicalTrials.gov NCT01780116，注册日期2013年1月29日。
