Azrin N H, Teichner G
Center for Psychological Studies, Nova Southeastern University, Fort Lauderdale, FL 33314, USA.
Behav Res Ther. 1998 Sep;36(9):849-61. doi: 10.1016/s0005-7967(98)00036-9.
Outpatient medication adherence is a major problem, especially for patients repeatedly hospitalized for psychiatric disorders. This study included 39 such patients who were receiving case management services from a community mental health center. Patients were matched and randomly assigned to receive in a single session either (1) information regarding medication and its benefits, (2) guidelines for assuring adherence which encompassed all phases related to pill-taking including filling prescriptions, use of a pill container, transportation, self-reminders, doctor's appointments and so forth, or (3) the same guidelines as (2) above but given in the presence of a family member who was enlisted in support. The results showed that adherence increased to about 94% after the guidelines were given for both the individual and family guideline procedure, whereas adherence remained unchanged at 73% after the medication information procedure. These results suggest a practical means for assuring a high level of medication adherence for patients with psychiatric disorders.
门诊患者的用药依从性是一个主要问题，对于因精神疾病反复住院的患者而言尤其如此。本研究纳入了39名正在接受社区心理健康中心个案管理服务的此类患者。将患者进行匹配并随机分配，使其在单次治疗中接受以下其中一种干预：（1）关于药物及其益处的信息；（2）确保依从性的指南，该指南涵盖与服药相关的所有阶段，包括开处方、使用药盒、交通、自我提醒、预约医生等等；或（3）与上述（2）相同的指南，但在有一名被招募来提供支持的家庭成员在场的情况下提供。结果显示，在为个体和家庭提供指南程序后，依从性提高到了约94%，而在提供药物信息程序后，依从性保持不变，为73%。这些结果提示了一种确保精神疾病患者高用药依从性的实用方法。
