Singh Sourabh Moti, Haddad Peter M, Husain Nusrat, Heaney Eamonn, Tomenson Barbara, Chaudhry Imran B
Lancashire Care NHS Foundation Trust, Preston, UK.
University of Manchester, Manchester, UK.
Ther Adv Psychopharmacol. 2016 Jun;6(3):162-71. doi: 10.1177/2045125316632458. Epub 2016 Mar 10.
The objective of this study was to compare patients' attitudes and satisfaction with medication and patient-rated tolerability between those prescribed a first-generation antipsychotic long-acting injection (FGA-LAI) and those prescribed risperidone long-acting injection (RLAI).
A cross-sectional study of a representative sample of outpatients prescribed an FGA-LAI or RLAI for a minimum of 6 months and attending a depot clinic. Attitudes to medication were assessed by the Drug Attitude Inventory (DAI-30), tolerability was measured by the Liverpool University Neuroleptic Side Effect Rating Scale (LUNSERS) and satisfaction with antipsychotic medication was assessed by the Satisfaction with Antipsychotic Medication (SWAM) scale.
The RLAI (n = 28) and FGA-LAI (n = 39) groups did not differ in terms of mean age, sex, diagnosis and ethnicity. All individual LAIs were prescribed within British National Formulary limits. The most commonly prescribed FGA-LAI was flupentixol decanoate (n = 22). There was no significant difference between the RLAI and FGA-LAI groups in terms of mean total scores on the DAI-30, LUNSERS and SWAM or the tolerability subscales of the LUNSERS or the two subscales (treatment acceptability and medication insight) of the SWAM. In both LAI groups there was a low level of side effects (LUNSERS) and a generally positive attitude (DAI-30) and reasonable satisfaction (SWAM) with medication.
Patients treated with FGA-LAI and RLAI for at least 6 months did not differ in terms of patient-rated tolerability, attitudes and satisfaction with medication. The current design cannot determine whether differences would have been evident earlier on during treatment. These results should be regarded as preliminary and are subject to prescribing bias. Randomized studies avoid prescribing bias and are a superior way to compare specific LAIs. Ideally randomized studies should include patient-rated outcome measures including medication tolerability; assessment of side effects, efficacy and quality of life made by blinded raters; and additional objective side-effect data including changes in weight and key blood parameters.
本研究的目的是比较接受第一代抗精神病长效注射剂（FGA-LAI）治疗的患者与接受利培酮长效注射剂（RLAI）治疗的患者对药物的态度、满意度以及患者自评的耐受性。
对一个具有代表性的门诊患者样本进行横断面研究，这些患者接受FGA-LAI或RLAI治疗至少6个月，并在一个长效注射剂诊所就诊。通过药物态度量表（DAI-30）评估对药物的态度，通过利物浦大学抗精神病药物副作用评定量表（LUNSERS）测量耐受性，并通过抗精神病药物满意度量表（SWAM）评估对抗精神病药物的满意度。
RLAI组（n = 28）和FGA-LAI组（n = 39）在平均年龄、性别、诊断和种族方面没有差异。所有个体长效注射剂的处方均在英国国家处方集的限制范围内。最常处方的FGA-LAI是癸酸氟哌噻吨（n = 22）。在DAI-30、LUNSERS和SWAM的平均总分方面，以及在LUNSERS的耐受性子量表或SWAM的两个子量表（治疗可接受性和药物洞察）方面，RLAI组和FGA-LAI组之间没有显著差异。在两个长效注射剂组中，副作用水平都较低（LUNSERS），对药物的态度总体上是积极的（DAI-30），并且对药物的满意度合理（SWAM）。
接受FGA-LAI和RLAI治疗至少6个月的患者在患者自评的耐受性、对药物的态度和满意度方面没有差异。当前的设计无法确定在治疗早期是否会出现明显差异。这些结果应被视为初步结果，并且存在处方偏倚。随机研究可以避免处方偏倚，是比较特定长效注射剂的更好方法。理想情况下，随机研究应包括患者自评的结局指标，包括药物耐受性；由盲法评估者对副作用、疗效和生活质量进行的评估；以及额外的客观副作用数据，包括体重和关键血液参数的变化。
