Nonadherence with mood stabilizers: Prevalence and predictors
Nonadherence with mood stabilizers: Prevalence and predictors
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DOI：
10.4088/jcp.v63n0502
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发表时间：
2002-05-01
影响因子：
5.3
通讯作者：
Pope, M
中科院分区：
文献类型：
--
作者：
Scott, J;Pope, M
背景：情绪稳定剂不依从的患病率约为18%至52%。只有1%的关于情绪稳定剂的出版物解决了这个问题。本研究的目的是探讨在一个队列的个人接受长期治疗情绪stabilizers.Method：受试者接受锂的情感障碍的患病率和预测不遵守。从生化实验室数据中鉴别出卡马西平和/或丙戊酸盐。这些受试者中有98名患有重度抑郁症（N = 20）或双相情感障碍（N = 78）（DSM-IV），并同意参加结构化临床访谈，以评估他们的药物依从性及其影响因素。结果：略低于50%的受试者（46/98）承认在过去2年中存在一定程度的药物不依从性，32%（29/92）的患者在上个月仅报告部分依从性（缺失30%或更多的处方药物）。后向逐步logistic回归分析表明，部分依从受试者与依从受试者的最佳区分是更频繁的既往不依从史。否认疾病的严重性，以及更长的持续时间被规定的情绪稳定剂。结论：情绪稳定剂不遵守率高。态度和行为比药物副作用更能预测不依从性。临床医生需要定期询问依从性问题。
Background: The prevalence of nonadherence with mood stabilizers ranges from about 18% to 52%. Only 1% of publications on mood stabilizers address this issue. This Study aimed to explore the prevalence and predictors of nonadherence in a cohort of individuals with affective disorders receiving long-term treatment with mood stabilizers.Method: Subjects receiving lithium. carbamazepine, and/or valproate were identified from biochemistry laboratory data. Ninety-eight of these subjects had major depressive disorder (N = 20) or bipolar disorder (N = 78) (DSM-IV) and gave informed consent to participate in a structured clinical interview to assess their medication adherence and the factors that influenced it.Results: Just under 50% of subjects (46/98) acknowledged some degree of medication nonadherence in the previous 2 years, and 32% (29/92) reported only partial adherence in the last month (missing 30% or more of their prescribed medication). Backward stepwise logistic regression demonstrated that partially adherent subjects were best distinguished from adherent subjects by a more frequent past history of nonadherence. denial of severity of illness, and greater duration of being prescribed a mood stabilizer.Conclusion; Rates of mood stabilizer nonadherence are high. Attitudes and behaviors are better predictors of nonadherence than side effects from medication. Clinicians need to inquire routinely about problems with adherence.