University of Portsmouth, Department of Sport and Exercise Science, Portsmouth, UK PO1 2UP.
Institute of Brain, Behaviour and Mental Health, University of Manchester, Manchester, UK M13 9PL.
Psychiatry Res. 2017 Apr;250:17-24. doi: 10.1016/j.psychres.2017.01.049. Epub 2017 Jan 21.
Individuals living with schizophrenia are 2-3 times more likely to experience type 2 diabetes mellitus. Diabetes medication adherence is essential to reduce morbidity and mortality in this population. We conducted a meta-analysis of diabetes medication adherence among people with schizophrenia, and compared this to those without schizophrenia. A systematic search strategy was used to identify all articles reporting adherence to diabetes medications among patients with schizophrenia. In total, 10 unique studies reporting data from 33,910 people with schizophrenia were included. Random effects meta-analysis showed people with schizophrenia adhered to medication on 77.3% of days prescribed (n=32080, 95%CI=73.6-81%, I=99.2%,), and adhered on 4.6% more days per year than those without schizophrenia (p<0.01, 95%CI=2.4-6.7%, I=92.5%, schizophrenia n=19367, controls=170,853). Furthermore, 56% of individuals with schizophrenia (n=33680) were considered "adherent" (i.e. >80% adherence over 12-24 month) to diabetes medication, which was significantly more than those without schizophrenia (OR=1.34, 95%CI: 1.18-1.52, p<0.01). Factors which were positively associated with diabetes medication adherence were age, number of outpatient visits, along with multiple medication administration variables. Future prospective research should examine diabetes monitoring, medication prescription, and subsequent adherence in fully representative samples. Novel interventions for maximizing compliance to diabetes medication in this vulnerable population should also be explored.
患有精神分裂症的个体患 2 型糖尿病的可能性是普通人群的 2-3 倍。糖尿病药物治疗的依从性对于降低该人群的发病率和死亡率至关重要。我们对精神分裂症患者的糖尿病药物治疗依从性进行了荟萃分析，并将其与非精神分裂症患者进行了比较。采用系统搜索策略来确定所有报告精神分裂症患者药物治疗依从性的文章。共有 10 项独特的研究报告了 33910 名精神分裂症患者的数据。随机效应荟萃分析显示，精神分裂症患者的药物治疗依从性为 95%置信区间为 73.6-81%（n=32080，I=99.2%），即他们在规定的用药天数中实际用药的天数占比为 77.3%，比非精神分裂症患者每年多用药 4.6%（p<0.01，95%置信区间为 2.4-6.7%，I=92.5%，精神分裂症患者 n=19367，对照组 n=170853）。此外，56%的精神分裂症患者（n=33680）被认为对糖尿病药物“依从”（即 12-24 个月内的用药依从率>80%），明显高于非精神分裂症患者（OR=1.34，95%置信区间：1.18-1.52，p<0.01）。与糖尿病药物治疗依从性呈正相关的因素包括年龄、门诊就诊次数以及多种药物管理变量。未来应在具有代表性的全人群样本中进行前瞻性研究，以评估糖尿病的监测、药物处方和后续的用药依从性。还应探索针对这一弱势群体的最大程度提高糖尿病药物依从性的新型干预措施。
