Department of Neuroscience, Biomedicine and Movement Sciences, Section of Psychiatry, WHO Collaborating Centre for Research and Training in Mental Health and Service Evaluation, University of Verona, Verona, Italy.
Epidemiol Psychiatr Sci. 2022 May 11;31:e34. doi: 10.1017/S2045796022000166.
Schizophrenia-spectrum disorders are associated with substantial impairment and disability. Lack of treatment adherence is a major issue, especially in low- and middle-income countries (LMICs). Despite growing evidence supporting second-generation long-acting antipsychotics (LAIs) as an effective strategy to ensure continued maintenance treatment in schizophrenia, access to these technologies has been very limited in constrained-resource settings. Including second-generation LAIs in national and international essential medicines lists and evidence-based guidelines, promoting public health-oriented patent pooling and extending their availability to primary health care settings, are key actions that should urgently be implemented to increase access to long-acting technologies. Implementing these policy actions can pragmatically improve treatment adherence, ultimately tackling schizophrenia-related impairment and disability in LMICs, which can be regarded as a global health priority.
精神分裂症谱系障碍与严重的损伤和残疾有关。治疗依从性差是一个主要问题，尤其是在中低收入国家（LMICs）。尽管越来越多的证据支持第二代长效抗精神病药（LAIs）作为确保精神分裂症持续维持治疗的有效策略，但在资源有限的情况下，这些技术的获得非常有限。将第二代 LAIs 纳入国家和国际基本药物清单和循证指南，促进以公共卫生为导向的专利池，并将其在初级卫生保健环境中的可及性扩大，是应紧急实施的关键行动，以增加对长效技术的获取。实施这些政策行动可以切实提高治疗依从性，最终解决中低收入国家与精神分裂症相关的损伤和残疾问题，这可以被视为全球卫生重点。
