Weiden P, Rapkin B, Zygmunt A, Mott T, Goldman D, Frances A
Schizophrenia Program, St. Luke's Roosevelt Hospital Center, New York, NY 10025, USA.
Psychiatr Serv. 1995 Oct;46(10):1049-54. doi: 10.1176/ps.46.10.1049.
This preliminary study assessed the effects on outpatient medication compliance of converting inpatients with schizophrenia from oral to depot neuroleptic medication.
Subjects consisted of 93 neuroleptic-responsive inpatients with schizophrenia from three New York City hospitals who were part of a one-year prospective longitudinal study of medication compliance. Forty patients were converted to depot neuroleptic medication while hospitalized; the other 53 remained on oral medication. Symptoms, side effects, and medication compliance of the two groups were compared at one, six, and 12 months postdischarge.
Inpatients converted to depot medication had significantly better compliance at one month postdischarge. Differences in demographic characteristics, symptoms, hospital site, and baseline attitudes toward medication did not account for this finding. The initial positive effect on compliance waned, and no significant between-group differences in compliance were found at six and 12 months postdischarge.
Conversion to depot medication before hospital discharge may facilitate medication compliance during transition to outpatient treatment, but other interventions are needed to maintain compliance over time.
本初步研究评估了将精神分裂症住院患者的抗精神病药物从口服剂型转换为长效剂型对门诊药物依从性的影响。
研究对象包括来自纽约市三家医院的93名对抗精神病药物有反应的精神分裂症住院患者，他们是一项为期一年的药物依从性前瞻性纵向研究的一部分。40名患者在住院期间转换为长效抗精神病药物治疗；另外53名患者继续接受口服药物治疗。在出院后1个月、6个月和12个月时比较两组患者的症状、副作用和药物依从性。
转换为长效药物治疗的住院患者在出院后1个月时的依从性显著更好。人口统计学特征、症状、医院地点以及对药物的基线态度方面的差异并不能解释这一结果。对依从性的初始积极影响逐渐减弱，在出院后6个月和12个月时，两组之间在依从性方面未发现显著差异。
出院前转换为长效药物治疗可能有助于在向门诊治疗过渡期间提高药物依从性，但需要其他干预措施来长期维持依从性。
