Compliance with medication regimens for mental and physical disorders
Compliance with medication regimens for mental and physical disorders
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DOI：
10.1176/ps.49.2.196
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发表时间：
1998-02-01
影响因子：
3.8
通讯作者：
Rosenheck, R
中科院分区：
文献类型：
--
作者：
Cramer, JA;Rosenheck, R
目的：作者回顾了精神科治疗中药物依从性的研究，并将依从率与躯体疾病治疗中的依从率进行了比较。方法：使用 MEDLINE 查找 1975 年至 1996 年精神科治疗用药依从性的文献报告。对这些报告和报告中引用的研究进行审查，以确定用于评估依从性的方法和报告的依从率。选择了 10 份描述评估方法并包括抗抑郁药物治疗依从率的报告和 24 份抗精神病药物报告。他们与 12 份使用微电子监测来评估患有一系列非精神疾病的患者的用药依从性的报告进行了比较。结果：对精神病患者的研究使用了各种方法来估计药物依从性，包括患者访谈、临床医生的判断和药物计数，但总体显示依从性较低。接受抗精神病药物的患者平均服用了推荐剂量的 58%，范围为 24% 至 90%。接受抗抑郁药物治疗的患者服用了推荐剂量的 65%，范围从 40% 到 90%。尽管微电子监测显示经常漏服药物和停药，但患有身体疾病的患者的平均依从率为 76%，范围为 60% 至 92%。结论：精神疾病患者对药物治疗方案的依从性可能低于躯体疾病患者。然而，这种差异可能很大程度上归因于用于估计依从性的方法。研究结果表明需要新的和改进的方法来监测依从性并提高患者对药物治疗的依从性。
Objective: The authors reviewed research on medication compliance in psychiatric treatment and compared compliance rates with compliance rates in treatment of physical disorders. Methods: MEDLINE was used to locate reports in the literature on medication compliance in psychiatric treatment for the years 1975 through 1996. These reports and studies cited in the reports were reviewed to determine the methods used to assess compliance and the compliance rates reported. Ten reports describing assessment methods and including medication compliance rates for antidepressant medication and 24 reports for antipsychotic medication were selected. They were compared with 12 reports that used microelectronic monitoring to assess medication compliance of patients with a range of nonpsychiatric disorders. Results: Studies of psychiatric patients used various methods of estimating medication compliance, including interviews with patients, clinicians' judgment, and pill counts, but overall showed low rates of compliance. Patients receiving antipsychotics took an average of 58 percent of the recommended amount of the medications, with a range from 24 to 90 percent. Patients receiving antidepressants took 65 percent of the recommended amount, with a range from 40 to 90 percent. The mean compliance rate for patients with physical disorders was 76 percent, with a range from 60 to 92 percent, although the microelectronic monitoring showed frequent omission of doses and discontinuation of medication. Conclusions: Compliance with medication regimens among patients with psychiatric disorders may be lower than among patients with physical disorders. However, the difference may be largely attributable to the methods used for estimating compliance, The findings suggest the need for new and improved methods for monitoring compliance and increasing patients' compliance with pharmacotherapy.