De Las Cuevas Carlos, Motuca Mariano, Baptista Trino, de Leon Jose
Department of Internal Medicine, Dermatology and Psychiatry, Universidad de La Laguna, Canary Islands, Spain.
Instituto Vilapriño, Center for Studies, Assistance and Research in Neurosciences, Mendoza, Argentina.
Patient Prefer Adherence. 2018 Feb 20;12:301-310. doi: 10.2147/PPA.S158443. eCollection 2018.
Cultural differences in attitudes toward psychiatric medications influence medication adherence but transcultural studies are missing. The objective of this study was to investigate how attitudes and beliefs toward psychotropic medications influence treatment adherence in psychiatric outpatients in Spain, Argentina, and Venezuela.
A cross-sectional, cross-cultural psychopharmacology study was designed to assess psychiatric outpatients' attitudes toward their prescribed medication. Patients completed the Drug Attitude Inventory - 10 Item (DAI-10), the Beliefs about Medicines Questionnaire - Specific Scale (BMQ-Specific), the Sidorkiewicz adherence tool, and sociodemographic and clinical questionnaires. The study included 1,291 adult psychiatric outpatients using 2,308 psychotropic drugs from three Spanish-speaking countries, the Canary Islands (Spain) (N=588 patients), Argentina (N=508), and Venezuela (N=195).
The univariate analyses showed different mean scores on the DAI-10 and the BMQ - Necessity and Concerns subscales but, on the other hand, the percentages of non-adherent and skeptical patients were relatively similar in three countries. Argentinian patients had a very low level of pharmacophobia. Multivariate analyses (logistic regression and chi-squared automatic interaction detector segmentation) showed that pharmacophobia in general and skepticism about specific medications (high concern about adverse reactions and low belief in their necessity) were associated with non-adherence. Pharmacophobia was the major factor associated with non-adherence (Spain and Venezuela) but when pharmacophobia was rare (Argentina), skepticism was the most important variable associated with non-adherence.
Psychiatric patients' attitudes and beliefs about their psychiatric treatment varied in these three Spanish-speaking countries, but pharmacophobia and skepticism appeared to play a consistent role in lack of adherence.
对精神科药物态度的文化差异会影响药物依从性，但跨文化研究尚付阙如。本研究的目的是调查西班牙、阿根廷和委内瑞拉精神科门诊患者对精神药物的态度和信念如何影响治疗依从性。
设计了一项横断面、跨文化精神药理学研究，以评估精神科门诊患者对其处方药物的态度。患者完成了药物态度量表-10项（DAI-10）、药物信念问卷-特定量表（BMQ-特定）、西多凯维茨依从性工具以及社会人口统计学和临床问卷。该研究纳入了来自三个西班牙语国家（西班牙加那利群岛（N = 588例患者）、阿根廷（N = 508例）和委内瑞拉（N = 195例））的1291例使用2308种精神药物的成年精神科门诊患者。
单因素分析显示，DAI-10以及BMQ-必要性和担忧分量表的平均得分有所不同，但另一方面，三个国家中不依从和持怀疑态度患者的百分比相对相似。阿根廷患者的药物恐惧水平非常低。多因素分析（逻辑回归和卡方自动交互检测器分割）显示，总体药物恐惧以及对特定药物的怀疑态度（对不良反应高度关注且对其必要性信念较低）与不依从相关。药物恐惧是与不依从相关的主要因素（西班牙和委内瑞拉），但在药物恐惧罕见的情况下（阿根廷），怀疑态度是与不依从相关的最重要变量。
在这三个西班牙语国家，精神科患者对其精神科治疗方案的态度和信念各不相同，但药物恐惧和怀疑态度似乎在不依从方面发挥了一致的作用。
