Li Xuping, Xiao Shuiyuan, Sun Yajun, Zheng Ying, Huang Jiaju, Wei Ning, Mao Chun, Zhang Shengjun, Teng Yongyong
Xiangya School of Public Health, Central South University, Changsha, Hunan, China.
The Third People's Hospital of Zhuhai, Zhuhai, Guangdong, China.
BMJ Open. 2025 Jan 25;15(1):e092073. doi: 10.1136/bmjopen-2024-092073.
To explore the factors influencing medication adherence and the medication needs of patients with schizophrenia when living in a community in China.
A qualitative study.
Community and psychiatric ward in Zhuhai city, Guangdong province.
Patients with schizophrenia and (or) their primary caregivers.
Facilitators and barriers of medication adherence and the medication needs.
A total of 20 patients with schizophrenia and 12 primary caregivers participated in the study. Based on the Health Ecology Model, the analysis identified four levels of factors influencing medication adherence, categorised as individual (facilitators: effective treatment, positive expectation, establishing a routine and assistive tools; barriers: side effects, inadequate knowledge, forgetfulness and irregular daily schedule), interpersonal (facilitators: caregiver assistance and psychiatrist's recommendation; barriers: lack of social support), community (facilitators: community mental health services and reducing medication use frequency; barriers: limited medication accessibility and affordability) and policy and culture related (facilitators: collectivist culture and social security policy; barriers: stigma). Additionally, five medication needs (managing side effects, applying for social security, improving medication accessibility, transitioning to long-acting injections and getting health education) were recognised.
These findings offer valuable insights for healthcare providers and policymakers, underscoring the need for targeted interventions to enhance medication adherence among patients with schizophrenia in China.
探讨影响中国社区精神分裂症患者服药依从性的因素及用药需求。
一项定性研究。
广东省珠海市的社区和精神科病房。
精神分裂症患者及(或)其主要照顾者。
服药依从性的促进因素和障碍以及用药需求。
共有20名精神分裂症患者和12名主要照顾者参与了本研究。基于健康生态模型,分析确定了影响服药依从性的四个因素层次,分类为个体因素(促进因素:有效治疗、积极期望、建立常规和辅助工具;障碍:副作用、知识不足、健忘和日常作息不规律)、人际因素(促进因素:照顾者协助和精神科医生建议;障碍:缺乏社会支持)、社区因素(促进因素:社区精神卫生服务和减少用药频率;障碍:药物可及性和可负担性有限)以及政策和文化相关因素(促进因素:集体主义文化和社会保障政策;障碍:污名化)。此外,还识别出了五种用药需求(管理副作用、申请社会保障、提高药物可及性、过渡到长效注射剂以及接受健康教育)。
这些发现为医疗服务提供者和政策制定者提供了有价值的见解,强调了在中国针对精神分裂症患者进行有针对性干预以提高服药依从性的必要性。