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精神分裂症的治疗目标:美国患者、精神科医生及护理人员的真实世界调查,兼析当前治疗(长效注射剂与口服抗精神病药物)及目标选择

Treatment Goals in Schizophrenia: A Real-World Survey of Patients, Psychiatrists, and Caregivers in the United States, with an Analysis of Current Treatment (Long-Acting Injectable vs Oral Antipsychotics) and Goal Selection.

作者信息

Fitzgerald Heather M, Shepherd Jason, Bailey Hollie, Berry Mia, Wright Jack, Chen Maxine

机构信息

Lundbeck LLC, Deerfield, IL, USA.

Adelphi Real World, Bollington, UK.

出版信息

Neuropsychiatr Dis Treat. 2021 Oct 21;17:3215-3228. doi: 10.2147/NDT.S330936. eCollection 2021.

Abstract

PURPOSE

To understand similarities and differences in patient treatment goals as selected by US psychiatrists, adult patients with schizophrenia, and their caregivers in a real-world setting in the United States, including stratification by current medication and age.

PATIENTS AND METHODS

Data were drawn from the Adelphi Schizophrenia Disease Specific Programme™, a point-in-time survey of psychiatrists and their consulting adult patients with schizophrenia, conducted from June to October 2019. Psychiatrists completed record forms for their next 8 consecutive outpatients and (where possible) 2 inpatients matching inclusion criteria. Participating psychiatrists, patients, and caregivers completed treatment goal questionnaires as part of the survey.

RESULTS

Psychiatrists (n = 124) provided data on 1204 patients with schizophrenia, including 1135 on drug treatment (207 inpatients [18%] and 928 outpatients [82%]); questionnaires were completed by 555 patients and 135 caregivers. Decrease in disease symptoms was identified as the most important patient treatment goal by patients (64%), psychiatrists (selecting for 63% of patients), and caregivers (selecting for 68% of patients). Patients, psychiatrists, and caregivers similarly rated the least important goals (less sexual problems and less weight gain). Patients indicated their current medication helped to reach their most important goals: decrease in disease symptoms (68%) and thinking more clearly (39%). Findings based on analysis of treatment goals by treatment and age were similar to overall trends.

CONCLUSION

These findings, including identification of a primary consensus goal of decrease in disease symptoms, may help with discussions between patients with schizophrenia, psychiatrists, and caregivers to inform effective management strategies and encourage shared decision-making.

摘要

目的

了解在美国的实际临床环境中,美国精神科医生、成年精神分裂症患者及其照料者所选择的患者治疗目标的异同,包括按当前用药情况和年龄进行分层。

患者与方法

数据来自阿德尔菲精神分裂症特定疾病项目™,这是一项于2019年6月至10月进行的针对精神科医生及其会诊的成年精神分裂症患者的时间点调查。精神科医生为其接下来连续的8名门诊患者以及(如有可能)2名符合纳入标准的住院患者填写记录表格。参与调查的精神科医生、患者和照料者完成了治疗目标问卷作为调查的一部分。

结果

124名精神科医生提供了1204例精神分裂症患者的数据,其中1135例接受药物治疗(207例住院患者[18%]和928例门诊患者[82%]);555例患者和135名照料者完成了问卷。患者(64%)、精神科医生(为63%的患者选择此项)和照料者(为68%的患者选择此项)均将疾病症状的减轻确定为最重要的患者治疗目标。患者、精神科医生和照料者对最不重要的目标(较少的性问题和较少的体重增加)的评分相似。患者表示其当前的药物治疗有助于实现其最重要的目标:疾病症状减轻(68%)和思维更清晰(39%)。基于治疗和年龄对治疗目标进行分析的结果与总体趋势相似。

结论

这些发现,包括确定疾病症状减轻这一主要共识目标,可能有助于精神分裂症患者、精神科医生和照料者之间的讨论,为有效的管理策略提供信息并鼓励共同决策。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cb75/8544790/8b8542e3dc3e/NDT-17-3215-g0001.jpg

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