精神分裂症患者药物不依从及其相关因素：埃塞俄比亚西北部的多中心横断面研究。
Medication non-adherence and associated factors among peoples with schizophrenia: multicenter cross-sectional study in Northwest Ethiopia.
机构信息
Department of Pharmacy, Health Science College, Debre Markos University, Debre Markos, Ethiopia.
Clinical Pharmacy Unit, Department of Pharmacy, College of Medicine and Health Science, Bahir Dar University, Bahir Dar, Ethiopia.
出版信息
BMC Psychiatry. 2024 Aug 19;24(1):567. doi: 10.1186/s12888-024-06004-7.
BACKGROUND
Schizophrenia is a serious and debilitating psychiatric disorder that is linked to marked social and occupational impairment. Despite the vital relevance of medication, non-adherence with recommended pharmacological treatments has been identified as a worldwide problem and is perhaps the most difficult component of treating schizophrenia. There are limited studies conducted on magnitude and potential factors of medication non-adherence among peoples with schizophrenia in Ethiopia.
OBJECTIVES
This study aimed to assess medication non-adherence and associated factors among peoples with schizophrenia at comprehensive specialized hospitals in Northwest Ethiopia.
METHODS
An institutional-based cross-sectional study was conducted among 387 peoples with schizophrenia at selected hospitals in the Northwest of Ethiopia from June to August 2022. Study participants were enrolled using systematic random sampling. Medication non-adherence was measured using Medication Adherence Rating Scale (MARS). Data entry and analysis were done using Epi-data version 4.6.0 and SPSS version 24, respectively. A multivariable logistic regression model was fitted to identify factors associated with medication non-adherence. Variables with a p-value of < 0.05 at a 95% confidence interval were considered statistically significant.
RESULTS
The prevalence of medication non-adherence was 51.2% (95% CI: 46.3, 56.3). Duration of treatment for more than ten years (AOR = 3.76, 95% CI: 1.43, 9.89), substance use (AOR = 1.92, 95% CI: 1.17, 3.13), antipsychotic polypharmacy, (AOR = 2.01, 95% CI: 1.11, 3.63) and extra-pyramidal side effect (AOR = 2.48, 95% CI: 1.24, 4.94) were significantly associated with medication non-adherence.
CONCLUSION
In this study, half of the participants were found to be medication non-adherent. Respondents with a longer duration of treatment, substance users, those on antipsychotic polypharmacy, and those who develop extra-pyramidal side effect need prompt screening and critical follow-up to improve medication adherence.
背景
精神分裂症是一种严重且使人虚弱的精神障碍，会导致明显的社交和职业障碍。尽管药物治疗至关重要，但不遵医嘱用药已被确定为全球性问题，而且可能是治疗精神分裂症最困难的部分。在埃塞俄比亚，针对精神分裂症患者药物不依从的程度和潜在因素进行的研究有限。
目的
本研究旨在评估西北埃塞俄比亚综合专科医院精神分裂症患者的药物不依从情况及其相关因素。
方法
2022 年 6 月至 8 月，在埃塞俄比亚西北部选定的医院进行了一项基于机构的横断面研究，共纳入 387 名精神分裂症患者。采用系统随机抽样法纳入研究对象。采用用药依从性评定量表（MARS）评估药物不依从情况。数据录入和分析分别使用 EpiData 版本 4.6.0 和 SPSS 版本 24。采用多变量逻辑回归模型来确定与药物不依从相关的因素。置信区间为 95%、p 值<0.05 的变量被认为具有统计学意义。
结果
药物不依从的患病率为 51.2%（95%CI：46.3，56.3）。治疗时间超过十年（AOR=3.76，95%CI：1.43，9.89）、物质使用（AOR=1.92，95%CI：1.17，3.13）、抗精神病药联合用药（AOR=2.01，95%CI：1.11，3.63）和锥体外系副作用（AOR=2.48，95%CI：1.24，4.94）与药物不依从显著相关。
结论
在这项研究中，发现一半的参与者存在药物不依从的情况。治疗时间较长、物质使用者、接受抗精神病药联合用药和出现锥体外系副作用的患者需要及时进行筛查和密切随访，以提高药物依从性。
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