Antipsychotic medication adherence: Is there a difference between typical and atypical agents?
Antipsychotic medication adherence: Is there a difference between typical and atypical agents?
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DOI：
10.1176/appi.ajp.159.1.103
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发表时间：
2002-01-01
影响因子：
17.7
通讯作者：
Jeste, DV
中科院分区：
文献类型：
--
作者：
Dolder, CR;Lacro, JP;Jeste, DV
目的：通过比较门诊退伍军人接受典型和非典型抗精神病药物治疗的服药依从性。方法：从计算机数据库中识别连续3个月内符合入选标准并接受氟哌啶醇(N=57)、奋乃静(N=60)、利培酮(N=80)、奥氮平(N=63)和奎硫平(N=28)处方的患者。本研究时的医院政策要求在开始非典型药物前至少有两种典型抗精神病药物试验失败，通过分析长达12个月的再治疗记录来计算患者对抗精神病药物方案的依从性。计算6个月和12个月的累积平均缺口比(不可用药天数与总天数之比)和依从性填充率(处方填写次数与处方填写总数之比)。结果：接受非典型抗精神病药物治疗的患者在6个月和12个月的依从率略高于接受典型药物治疗的患者。12个月时，典型抗精神病药物的累积平均缺口比为23.2%，非典型抗精神病药物的累积平均缺口比为14.1%；因此，接受典型药物治疗的患者平均每月有7天没有服药，而接受非典型药物治疗的患者每月有4天没有服药。在12个月时，典型抗精神病药物的依从性填充率为50.1%，非典型抗精神病药物的依从性填充率为54.9%。结论：即使是接受非典型抗精神病药物治疗的患者，也有必要进行干预以提高依从性。
Objective: Pharmacy refill records were used to compare medication adherence in outpatient veterans receiving typical versus atypical antipsychotic medications.Method: Consecutive patients meeting selection criteria and receiving prescriptions for haloperidol (N=57), perphenazine (N=60), risperidone (N=80), olanzapine (N=63), and quetiapine (N=28) over a 3-month period were identified from a computerized database, The hospital policy at the time of this study required failure in trials of at least two typical antipsychotics before initiation of an atypical agent, Patients' adherence with the antipsychotic regimen was calculated by analyzing refill records for up to 12 months. The cumulative mean gap ratio (the number of days when medication was unavailable in relation to the total number of days) and the compliant fill rate (the number of prescription fills indicating adherence in relation to the total number of prescription fills) at 6 and 12 months were calculated.Results: Adherence rates at 6 and 12 months were moderately higher in patients who received atypical antipsychotics than in those who received typical agents. Cumulative mean gap ratios were 23.2% for typical and 14.1% for atypical antipsychotics at 12 months; thus, patients who received typical agents were without medication for an average of 7 days per month, compared with 4 days per month for those who received atypical agents. At 12 months, compliant fill rates were 50.1% for typical and 54.9% for atypical antipsychotics.Conclusions, Interventions to improve adherence are warranted even for patients who receive atypical antipsychotic medications.