Kikkert Martijn J, Dekker Jack
Research Department, Arkin Mental Health Care Institute, Klaprozenweg 111, Amsterdam, Noord Holland 1033 NN, The Netherlands.
Research Department, Arkin Mental Health Care Institute, Amsterdam, The Netherlands.
Prim Care Companion CNS Disord. 2017 Dec 7;19(6):17n02182. doi: 10.4088/PCC.17n02182.
Medication nonadherence is common in patients with schizophrenia. Nonadherence affects approximately half of all patients and may increase the risk of relapse and hospitalization. Although it is an intensively studied phenomenon, we have little understanding of underlying mechanisms leading to nonadherence. In this article, using quantitative and qualitative study results and psychological decision theory, we present a model of medication adherence decisions in patients with schizophrenia that may be useful for clinicians and those involved in the development of adherence interventions or adherence research. The model focuses on the function and meaning of medication from a patient perspective. Although the model is a simplified description of the decision-making process related to medication use, it does explain the role of some important aspects such as insight, side effects, efficacy, and social influences. We also discuss how this may explain the high and persistent rates of nonadherence. Finally, we discuss some implications for clinical practice..
药物治疗不依从在精神分裂症患者中很常见。不依从影响着大约一半的患者，并且可能增加复发和住院的风险。尽管这是一个经过深入研究的现象，但我们对导致不依从的潜在机制了解甚少。在本文中，我们运用定量和定性研究结果以及心理决策理论，提出了一个精神分裂症患者药物治疗依从性决策模型，该模型可能对临床医生以及参与依从性干预或依从性研究开发的人员有用。该模型从患者角度关注药物的功能和意义。尽管该模型是对与药物使用相关决策过程的简化描述，但它确实解释了一些重要方面的作用，如洞察力、副作用、疗效和社会影响。我们还讨论了这如何解释高且持续的不依从率。最后，我们讨论了对临床实践的一些启示。
