University of Texas Health Science Center at San Antonio, San Antonio, TX, USA.
University of Texas Health Science Center at San Antonio, San Antonio, TX, USA.
Schizophr Res. 2020 Jan;215:17-24. doi: 10.1016/j.schres.2019.11.022. Epub 2019 Nov 22.
In a previous review, spanning 3 decades, we found that self-report and other non-objective measures were the primary means of assessing adherence to oral antipsychotic medications for individuals with schizophrenia. Moreover, consensus regarding the definition of adherence was completely lacking. Here, we examined the next decade of studies to determine what may have changed.
We searched the peer reviewed literature published between January 1, 2007 and December 31, 2017 using Google scholar, Science Direct, CINAHL, PsychINFO, PsychARTICLES and Medline. Search terms were medication adherence or medication compliance or medication acceptance or medication follow-through or medication concordance or medication persistence AND schizophrenia. We included articles that assessed adherence behavior.
The search yielded 663 articles, 363 of these were eliminated. Included studies represent over 560,000 individuals. Definitions of adherence remain variable with cutoffs from 67% to 95%. Subjective measures of adherence remain the most commonly used. However, the use of objective measures has significantly increased, as has the use of electronic claims data. However, the absolute number of studies using objective measures remains low and very few approaches identify the amount of medication actually taken.
Some movement toward more standardization and the use of more objective measures of adherence has been made over the past decade. However, objective measures continue to be underutilized and definitions remain variable. Assessing adherence in less than optimal ways calls into question the results of studies purporting to identify reasons for problem adherence and to elucidate the relationships among adherence and other variables.
在之前的一篇综述中，我们回顾了过去 30 年的研究，发现自我报告和其他非客观测量方法是评估精神分裂症患者口服抗精神病药物依从性的主要手段。此外，对于依从性的定义完全缺乏共识。在这里，我们检查了下一个十年的研究，以确定可能发生了哪些变化。
我们使用 Google 学术、Science Direct、CINAHL、PsychINFO、PsychARTICLES 和 Medline 搜索了 2007 年 1 月 1 日至 2017 年 12 月 31 日期间发表的同行评审文献。搜索词为药物依从性或药物一致性或药物接受或药物坚持或药物一致性或药物持久性和精神分裂症。我们纳入了评估依从性行为的文章。
搜索结果产生了 663 篇文章，其中 363 篇被排除。纳入的研究代表了超过 56 万人。依从性的定义仍然存在差异，从 67%到 95%不等。主观的依从性测量仍然是最常用的。然而，客观测量的使用显著增加，电子索赔数据的使用也显著增加。然而，使用客观测量的研究数量仍然很少，很少有方法能确定实际服用的药物量。
在过去的十年中，在更标准化和使用更客观的依从性测量方面已经取得了一些进展。然而，客观测量的方法仍然没有得到充分利用，定义仍然存在差异。以不最佳的方式评估依从性会对声称确定依从性问题的原因以及阐明依从性与其他变量之间关系的研究结果提出质疑。
