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虚拟护士支持以提高精神分裂症患者对抗精神病药物的依从性:南非视角

Virtual nurse support to enhance antipsychotic adherence in schizophrenia: A South African perspective.

作者信息

Thandar Yasmeen, Mvunelo Nomhle, Singh Deepak, Haffejee Firoza

机构信息

Department of Basic Medical Sciences, Faculty of Health Sciences, Durban University of Technology, Durban, South Africa.

Department of Physics, Faculty of Applied Sciences, Durban University of Technology, Durban, South Africa.

出版信息

S Afr J Psychiatr. 2025 May 31;31:2430. doi: 10.4102/sajpsychiatry.v31i0.2430. eCollection 2025.

Abstract

BACKGROUND

Patients with schizophrenia rely on antipsychotic medication, with adherence being critical for symptom management. Poor adherence leads to relapse, disability and increased healthcare costs.

AIM

This study investigated the impact on antipsychotic adherence among schizophrenia patients on the introduction of an intervention utilising a psychiatric nurse as a virtual treatment buddy.

SETTING

Participants were recruited from a psychiatric clinic in KwaZulu-Natal, South Africa.

METHODS

This quantitative pre-test-post-test control group study recruited 117 schizophrenia patients. Participants were randomly assigned to an intervention group ( = 82) receiving daily text message support or a control group ( = 35) without support. Pre- and post-intervention questionnaires assessed medication adherence. The McNemar test compared medication cessation frequencies pre- and post-intervention. Pearson's chi-squared test, factor analysis and linear regressions were employed to correlate variables. A < 0.05 was deemed statistically significant.

RESULTS

Adherence improved from 60.8% to 83.51% post-intervention ( < 0.001). Obstacles to adherence, including inadequate disease knowledge, treatment duration, side effects, misunderstanding instructions and forgetfulness, were reduced post-intervention. Additionally, symptom relapse, rehospitalisation, specialist referrals, the need for more potent medication and employment loss decreased post-intervention.

CONCLUSION

Virtual buddy support has demonstrated promise in improving medication adherence and minimising adverse effects of discontinuation among schizophrenia patients.

CONTRIBUTION

This study contributes a method to improving antipsychotic adherence and reducing negative outcomes in schizophrenia patients by emphasising personalised support, education and collaborative care among healthcare providers and support systems.

摘要

背景

精神分裂症患者依赖抗精神病药物治疗,服药依从性对于症状管理至关重要。依从性差会导致病情复发、残疾并增加医疗成本。

目的

本研究调查了引入一项干预措施(利用精神科护士作为虚拟治疗伙伴)对精神分裂症患者抗精神病药物依从性的影响。

设置

参与者从南非夸祖鲁 - 纳塔尔省的一家精神科诊所招募。

方法

这项定量的前后测对照组研究招募了117名精神分裂症患者。参与者被随机分配到接受每日短信支持的干预组(n = 82)或无支持的对照组(n = 35)。干预前后的问卷评估了药物依从性。McNemar检验比较了干预前后的停药频率。采用Pearson卡方检验、因子分析和线性回归来关联变量。P < 0.05被认为具有统计学意义。

结果

干预后依从性从60.8%提高到83.51%(P < 0.001)。干预后,包括疾病知识不足、治疗持续时间、副作用、误解医嘱和遗忘等依从性障碍有所减少。此外,干预后症状复发、再次住院、转介给专科医生、需要更强效药物治疗以及失业情况均有所减少。

结论

虚拟伙伴支持在提高精神分裂症患者的药物依从性和减少停药不良反应方面显示出前景。

贡献

本研究通过强调医疗服务提供者和支持系统之间的个性化支持、教育和协作护理,为提高精神分裂症患者的抗精神病药物依从性和减少负面结果贡献了一种方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/68e9/12135715/1fc526e13f16/SAJPsy-31-2430-g001.jpg

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