Cahaya Noor, Kristina Susi Ari, Widayanti Anna Wahyuni, Green James
Doctoral Program in Pharmacy, Faculty of Pharmacy, Universitas Gadjah Mada, Yogyakarta, Indonesia.
Department of Pharmacy, Faculty of Mathematics and Science, Universitas Lambung Mangkurat, Banjarbaru, Indonesia.
Patient Prefer Adherence. 2022 Sep 1;16:2431-2449. doi: 10.2147/PPA.S378951. eCollection 2022.
Nonadherence to medications is very common in people with schizophrenia. Numerous methods have been implemented to improve medication adherence. The study aimed to determine what interventions have been used and to assess the effectiveness of these in improving medication adherence in people with schizophrenia. Two electronic databases (PubMed and Science Direct) and a manual search were used to locate RCT studies that examined interventions in medication adherence for schizophrenia, published between 2011 and 2022. The search was conducted using the terms (schizophrenia OR schizophrenic) AND (interventions OR adherence therapy) AND (medication adherence OR medication compliance). Sixteen studies were included, and relevant data were extracted and selected. Sixteen studies used interventions that involve family, health professionals (psychiatrists, psychologists, nurses, and pharmacists), SMS, and smart electronic reminders. Medication adherence was measured using medication refill records from hospital dispensing records or claim databases, electronic devices, plasma blood concentration, and participant self-reporting. Thirteen out of 15 studies showed significant improvements in adherence compared to routine care. The other three studies did not result in improved medication adherence. Interventions with diverse strategies delivered to individuals with schizophrenia showed the potential to reduce medication non-adherence in people with schizophrenia so that they can be utilized as an alternative to support treatment in people with schizophrenia in addition to antipsychotic medication. In future research strategies, it will be necessary to identify the main problems regarding nonadherence in people with schizophrenia individually and also identify the patient's perception of medication, illness, and behavior when taking medication in order to determine the next intervention that will be appropriate based on the patient's needs to improve adherence.
精神分裂症患者不遵医嘱服药的情况非常普遍。已经实施了许多方法来提高服药依从性。该研究旨在确定使用了哪些干预措施,并评估这些措施在提高精神分裂症患者服药依从性方面的有效性。使用两个电子数据库(PubMed和科学Direct)并进行人工检索,以查找2011年至2022年期间发表的关于精神分裂症服药依从性干预措施的随机对照试验(RCT)研究。检索使用的关键词为(精神分裂症或精神分裂症患者)AND(干预措施或依从性治疗)AND(服药依从性或药物治疗依从性)。纳入了16项研究,并提取和筛选了相关数据。16项研究使用的干预措施涉及家庭、卫生专业人员(精神科医生、心理学家、护士和药剂师)、短信和智能电子提醒。使用医院配药记录或理赔数据库中的药物 refill 记录、电子设备、血浆血药浓度和参与者自我报告来衡量服药依从性。15项研究中有13项显示与常规护理相比,依从性有显著改善。另外三项研究没有使服药依从性得到改善。对精神分裂症患者实施的具有多种策略的干预措施显示出降低精神分裂症患者服药不依从性的潜力,因此除抗精神病药物外,这些干预措施可作为支持精神分裂症患者治疗的替代方法。在未来的研究策略中,有必要分别确定精神分裂症患者不依从的主要问题,并确定患者在服药时对药物、疾病和行为的认知,以便根据患者的需求确定下一个合适的干预措施以提高依从性。