Department of Clinical Pharmacy, Faculty of Pharmacy.
Department of Psychiatry, Faculty of Medicine, Hacettepe University, Ankara, Turkey.
Int Clin Psychopharmacol. 2019 Nov;34(6):298-304. doi: 10.1097/YIC.0000000000000280.
The inability of patients with psychiatric illness to achieve full compliance with treatment during the postdischarge period is a major problem. In this study, our aim was to evaluate whether drug education provided by a clinical pharmacist during discharging period has an effect on compliance. Forty adult patients diagnosed with psychotic disorders were included. A number of scales were used to evaluate the severity of illness, medication adverse effects and compliance. At time of discharge, it was emphasized to patients by a clinical pharmacist that medication compliance was important to prevent exacerbation or hospitalization. Six to eight weeks after discharge, patients were invited to be reevaluated using the same scales as those applied during hospitalization. There was a statistically significant increase in compliance after drug education (P < 0.001). A decrease in the baseline compliance score was associated with an increase in the total number of hospitalizations and the number of psychotropic drugs used. When the risk factors that may affect compliance were evaluated, akathisia was found to have the highest impact on compliance (P = 0.012). It is necessary to take advantage of counseling on medication use and to develop strategies in order to improve compliance in psychiatry.
精神疾病患者在出院后无法完全遵医嘱治疗是一个主要问题。本研究旨在评估临床药师在出院期间提供药物教育对遵医嘱的影响。共纳入 40 名被诊断为精神障碍的成年患者。使用多种量表评估疾病严重程度、药物不良反应和遵医嘱情况。在出院时,临床药师向患者强调遵医嘱的重要性,以防止病情恶化或住院。出院后 6 至 8 周,使用与住院期间相同的量表邀请患者重新评估。药物教育后遵医嘱情况有显著统计学改善(P<0.001)。基线遵医嘱评分下降与住院次数和使用精神药物数量增加相关。评估可能影响遵医嘱的风险因素时,发现静坐不能对遵医嘱的影响最大(P=0.012)。有必要利用药物使用咨询并制定策略,以提高精神科的遵医嘱情况。