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精神分裂症患者药物依从性与门诊治疗时长之间的关联

Association between Medication Adherence and Duration of Outpatient Treatment in Patients with Schizophrenia.

作者信息

Tarutani Seiichiro, Kikuyama Hiroki, Ohta Munehiro, Kanazawa Tetsufumi, Okamura Takehiko, Yoneda Hiroshi

机构信息

Department of Psychiatry, Shin-Abuyama Hospital, Osaka Institute of Clinical Psychiatry, Osaka, Japan.; Department of Neuropsychiatry, Osaka Medical College, Osaka, Japan.

Department of Psychiatry, Shin-Abuyama Hospital, Osaka Institute of Clinical Psychiatry, Osaka, Japan.

出版信息

Psychiatry Investig. 2016 Jul;13(4):413-9. doi: 10.4306/pi.2016.13.4.413. Epub 2016 Jul 25.

Abstract

OBJECTIVE

Medication adherence is important in the treatment of schizophrenia, and critical periods during treatment may be associated with relapse. However, the relationship between adherence and duration of outpatient treatment (DOT) remains unclear. The authors aimed to clarify the relationship between adherence and DOT at a psychiatric hospital in Japan.

METHODS

For outpatients with schizophrenia who regularly visit Shin-Abuyama hospital, the authors conducted a single questionnaire survey (five questions covering gender, age, DOT, medication shortages, and residual medication) over one month period. Participants were divided into two groups whether DOT were from more than one year to within five years or not. Mantel-Haenszel analysis and logistic regression analysis were performed on the data regarding the medication adherence.

RESULTS

Effective answers were received for 328 patients. The residual medication rate was significantly higher among those receiving outpatient treatment from more than one year to within five years than five years than those receiving outpatient treatment for more than five years or less than one year (p=0.016).

CONCLUSION

This survey suggests that there are critical periods during which patients are most prone to poor adherence. Because poor adherence increases the risk of relapse, specific measures must be taken to improve adherence during these periods.

摘要

目的

药物依从性在精神分裂症治疗中很重要,治疗期间的关键时期可能与复发有关。然而,依从性与门诊治疗时长(DOT)之间的关系仍不明确。作者旨在阐明日本一家精神病医院中依从性与DOT之间的关系。

方法

对于定期前往新阿部山医院就诊的精神分裂症门诊患者,作者在一个月的时间内进行了一次问卷调查(五个问题,涵盖性别、年龄、DOT、药物短缺和剩余药物)。根据DOT是否在一年以上至五年以内,将参与者分为两组。对有关药物依从性的数据进行Mantel-Haenszel分析和逻辑回归分析。

结果

共收到328名患者的有效答案。接受门诊治疗一年以上至五年以内的患者的剩余药物率显著高于接受门诊治疗五年以上或一年以内的患者(p = 0.016)。

结论

这项调查表明,存在患者最容易出现依从性差的关键时期。由于依从性差会增加复发风险,因此必须采取具体措施在这些时期提高依从性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/31d2/4965651/a11b960d1270/pi-13-413-g001.jpg

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